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)< FM/7V34 /, «i I N(TI - T»S- T ^- G 



The 
NORTH CAROLINA 

REGISTER 



IN THIS ISSUE 



FINAL DECISION LETTER 



A 



B 



CONa 

TITUl 

itiokI 



PROPOSED RULES 

Environment, Health, and Natural Resources 

Medical Examiners, Board of 

Physical Therapy Examiners recfi 

State Personnel 

JUL 8 1991 

CAW LIBRARY 
ARRC OBJECTIONS T 



RULES INVALIDATED BY JUDICIAL DECISION 



ISSUE DATE: JULY 1 , 1991 



Volume 6 • Issue 7 • Pages 326-373 



INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATIVE CODE 



NORTH CAROLINA REGISTER 

The North Carolina Register is published bi-monthly 
and contains information relating to agency, executive, 
legislative and judicial actions required by or affecting 
Chapter 150B of the General Statutes. All proposed, ad- 
ministrative rules and amendments filed under Chapter 
150B must be published in the Register. The Register 
will typically comprise approximately fifty pages per 
issue of legal text. 

State law requires that a copy of each issue be pro- 
vided free of charge to each county in the state and to 
various state officials and institutions. The North Carolina 
Register is available by yearly subscription at a cost of 
one hundred and five dollars ($105.00) for 24 issues. 

Requests for subscriptions to the North Carolina 
Register should be directed to the Office of Ad- 
ministrative Hearings, P. O. Drawer 27447, Raleigh, N. 
C. 27611-7447, Attn: Subscriptions. 

ADOPTION, AMENDMENT, AND REPEAL OF 
RULES 

An agency intending to adopt, amend, or repeal a rule 
must first publish notice of the proposed action in the 
North Carolina Register. The notice must include the 
time and place of the public hearing; a statement of how 
public comments may be submitted to the agency either 
at the hearing or otherwise; the text of the proposed 
rule or amendment; a reference to the Statutory 
Authority for the action and the proposed effective date. 

The Director of the Office of Administrative Hearings 
has authority to publish a summary, rather than the 
full text, of any amendment which is considered to be 
too lengthy. In such case, the full text of the rule con- 
taining the proposed amendment will be available for 
public inspection at the Rules Division of the Office of 
Administrative Hearings and at the office of the pro- 
mulgating agency. 

Unless a specific statute provides otherwise, at least 
30 days must elapse following publication of the pro- 
posal in the North Carolina Register before the agency 
may conduct the required public hearing and take ac- 
tion on the proposed adoption, amendment or repeal. 

When final action is taken, the promulgating agency 
must file any adopted or amended rule for approval by 
the Administrative Rules Review Commission. Upon ap- 
proval of ARRC, the adopted or amended rule must be 
filed with the Office of Administrative Hearings. If it 
differs substantially from the proposed form published 
as part of the public notice, upon request by the agen- 
cy, the adopted version will again be published in the 
North Carolina Register. 

A rule, or amended rule cannot become effective 
earlier than the first day of the second calendar month 
after the adoption is filed with the Office of Ad- 
ministrative Hearings for publication in the NCAC. 

Proposed action on rules may be withdrawn by the 
promulgating agency at any time before final action is 
taken by the agency. 

TEMPORARY RULES 

Under certain conditions of an emergency nature, 
some agencies may issue temporary rules. A temporary 
rule becomes effective when adopted and remains in 



effect for the period specified in the rule or 180 days 
whichever is less. An agency adopting a temporary rul 
must begin normal rule-making procedures on the per 
manent rule at the same time the temporary rule i 
adopted. 

NORTH CAROLINA ADMINISTRATIVE CODE 

The North Carolina Administrative Code (NCAC) i 
a compilation and index of the administrative rules c 
25 state agencies and 38 occupational licensing board: 
The NCAC comprises approximately 15,000 letter size 
single spaced pages of material of which approximatf 
ly 35% is changed annually. Compilation and public 
tion of the NCAC is mandated by G.S. 150B-63(b). 

The Code is divided into Titles and Chapters. Eac 
state agency is assigned a separate title which is fu 
ther broken down by chapters. Title 21 is designate 
for occupational licensing boards. 

The NCAC is available in two formats. 

(1) Single pages may be obtained at a minimui 
cost of two dollars and 50 cents ($2.50) for 1 
pages or less, plus fifteen cents ($0. 1 5) per eac 
additional page. 

(2) The full publication consists of 53 volume 
totaling in excess of 15,000 pages. It is su 
plemented monthly with replacement pages 
one year subscription to the full publication i 
eluding supplements can be purchased fi 
seven hundred and fifty dollars ($750.00). I 
dividual volumes may also be purchased wi 
supplement service. Renewal subscriptions f< 
supplements to the initial publication availab 

Requests for pages of rules or volumes of the NC/ 
should be directed to the Office of Administrati 
Hearings. 

NOTE 

The foregoing is a generalized statement of the pi 
cedures to be followed. For specific statutory languaj 
it is suggested that Articles 2 and 5 of Chapter 150B 
the General Statutes be examined carefully. 

CITATION TO THE NORTH CAROLINA 
REGISTER 

The North Carolina Register is cited by volume, issi 
page number and date. 1:1 NCR 101-201, April 1, 19 

refers to Volume 1, Issue 1, pages 101 through 201 
the North Carolina Register issued on April 1, 198 






North Carolina Register. Published bi-monthly by the 
Office of Administrative Hearings, P.O. Drawer 27447, 
Raleigh, North Carolina 27611-7447, pursuant tc 
Chapter 150B of the General Statutes. Subscription; 
one hundred and five dollars ($105.00) per year. 

North Carolina Administrative Code. Published ir 
looseleaf notebooks with supplement service by the 
Office of Administrative Hearings, P.O. Drawer 27447 
Raleigh, North Carolina 27611-7447, pursuant tc 
Chapter 150B of the General Satutes. Subscription; 
seven hundred and fifty dollars ($750.00). Individua 
volumes available. 






NORTH 
CAROLINA 
REGISTER 



ISSUE CONTENTS 




Office of Administrative Hearings 

P. O. Drawer 27447 

Ralegh, NC 27611-7447 

(919) 733 - 2678 



Julian Mann III, 

Director 
James R. Scarcella St., 

Deputy Director 
Molly Masich, 

Director APA Services 



I. FLNAL DECISION LETTER 

Voting Rights Act 326 



II. PROPOSED RULES 

Environment, Health, and 
Natural Resources 

Health Services 327 

Licensing Boards 

Medical Examiners 363 

Physical Therapy Examiners.... 363 
Office of State Personnel 

State Personnel Commission ...364 



III. ARRC OBJECTIONS 366 

IV. RULES INVALIDATED BY 

JUDICIAL DECISION 370 

V. CUMULATIVE LNDEX 372 



Staff: 

Ruby Creech, 

Publications Coordinator 
Teresa Kilpatrick, 

Editorial Assistant 
Jean Shirley, 

Editorial Assistant 



NORTH CAROLINA REGISTER 

Publication Schedule 

(April 1991 - December 1992) 



Issue 


Last Dav 


Last Day 


Farliest 


* 


Date 


for 


for 


Date for 


Earliest 




Filing 


Electronic 


Public 


Effective 






Filing 


Hearing & 
Adoption by 
Agency 


Date 


******** 


******** 


******** 


******** 


******** 


04/01/91 


03/11/91 


03/18/91 


05/01/91 


08 0191 


04/15/91 


03/22/91 


04/01/91 


05/15/91 


08 01,91 


05/01/91 


04/10/91 


04/17/91 


05/31/91 


09/01/91 


05/15/91 


04/24/91 


05/01/91 


06/14/91 


09/01/91 


06/03/91 


05/10/91 


05/17/91 


07/03/91 


10/0191 


06/14/91 


05/23/91 


05/31/91 


07/14/91 


10/01/91 


07,01/91 


06/10/91 


06/17/91 


07/3191 


1 1/01/91 


07/15/91 


06/21/91 


06/28/91 


08/14,91 


11/01/91 


08/01/91 


07/11/91 


07/18/91 


08/31/91 


12/01/91 


08/15/91 


07/25/91 


08/01/91 


09/14/91 


12/01/91 


09/03/91 


08/12/91 


08/19/91 


10/03/91 


01/01/92 


09 1691 


08/23/91 


08/30/91 


10/16/91 


01 01 92 


10/01/91 


09/10/91 


09/17/91 


10,31/91 


02/01/92 


10/15/91 


09/24/91 


10/01/91 


11/14/91 


02,01/92 


11/01/91 


10/11/91 


10/18/91 


12/01/91 


03/01/92 


11/15/91 


10/24/91 


10/31/91 


12/15/91 


03 01 92 


12/02/91 


11/07/91 


11/14/91 


01/01/92 


04 01/92 


12/16/91 


11/21/91 


12 0291 


01/15,92 


04 01/92 


01/02,92 


12/09/91 


12/16/91 


01/31 92 


05,01/92 


01/15/92 


12/20/91 


12/31/91 


02 14/92 


05 01 92 


02/03/92 


01 10/92 


01/1792 


03/04/92 


06 01 92 


02/14/92 


01/24/92 


01/31/92 


(13 15 92 


06/01/92 


03 02,92 


02/10/92 


02/17/92 


04 01/92 


07 01/92 


03. 16 92 


02/24 92 


03/02/92 


04/15,92 


07,01,92 


04/01/92 


03/11/92 


03/18/92 


05/01/92 


08/01/92 


04/15/92 


03/25/92 


04 '01 '92 


05/15/92 


08 01,92 


05/01/92 


04 10 92 


04/17/92 


05/31/92 


09,01/92 


05/15/92 


04/24/92 


05/01/92 


06/14/92 


09/01/92 


06 01,92 


05 11.92 


05 18 92 


07,01,92 


10 01.92 


06/15/92 


05/25/92 


06/01/92 


07/15,92 


10/01/92 


07/01,92 


06 10,92 


06/17/92 


07/31/92 


11 0192 


07/15/92 


06/24/92 


07 01 92 


08/14/92 


11,01/92 


08/03/92 


07/13/92 


07/20/92 


09/02/92 


12,01/92 


08/14/92 


07/24/92 


07,31 92 


091392 


12 0192 


09/01/92 


08 11 92 


08/18/92 


10 01 92 


01/01,93 


09/15/92 


08/25/92 


09/01/92 


10/15/92 


01/01.93 


10 01 92 


09, 10 92 


0917/92 


10/31,92 


02 01 93 


10/15/92 


09/24/92 


10/01 92 


11/14/92 


02 01.93 


11/02/92 


10 12 92 


10 1992 


12/02/92 


03 01 93 


11/16/92 


10 23 92 


10 30 92 


12/16/92 


03 01 93 


12 01 92 


11 06,92 


11 13 92 


12 31 92 


04 01 93 


12/15,92 


11/24,92 


12 01/92 


01/14/93 


04 01 93 



* The "Earliest Effective Date" is computed assuming that the public hearing 
and adoption occur in the calendar month immediately following the "Issue 
Date", that the agency files the tide with The Administralh'e Rules Review 
Commission by the 20th of the same calendar month and that ARRC approves 
the rule at the next calendar month meeting. 



VOTING RIGHTS ACT FINAL DECISION LETTER 



[G.S. 120-30.9H, effective July 16, 1986, requires that all letters and other documents issued by the 
Attorney General of the United States in which a final decision is made concerning a "change af- 
fecting voting" under Section 5 of the Voting Rights Act of J 965 be published in the North Carolina 
Register. / 



U.S. Department of Justice 
Civil Rights Division 

JRD:SSC:TGL:gmh 

DJ 166-012-3 Voting Section 

91-1124 P.O. Box 66128 

Washington, D.C. 20035-6128 



June 12, 1991 



Jesse L. Warren, Esq. 

City Attorney 

P. O. Drawer W-2 

Greensboro, North Carolina 27402 

Dear Mr. Warren: 



This refers to the annexation (Ordinance No. 91-33) and the designation of the annexed area to a 
district for the City of Greensboro in Guilford County, North Carolina, submitted to the Attorney 
General pursuant to Section 5 of the Voting Rights Act of 1965, as amended, 42 U.S.C. 1973c. We 
received your submission on April 15, 1991. 

The Attorney General does not interpose any objection to the specified change. However, we note 
that Section 5 expressly provides that the failure of the Attorney General to object does not bar sub- 
sequent litigation to enjoin the enforcement of the change. See the Procedures for the Administration 
of Section 5(28 C.F.R. 51.41). 

Sincerely, 

John R. Dunne 

Assistant Attorney General 

Civil Rights Division 



By: 



Gerald W. Jones 
Chief, Voting Section 



6:7 NORTH CAROLINA REGISTER July I, 1991 326 



PROPOSED RULES 



TITLE 15A - DEPARTMENT OE 

ENVIRONMENT, HEALTH, AND 

NATURAL RESOURCES 

ivotice is hereby given in accordance with G.S. 
1 SOB- 1 2 that the Commission for Health Services, 
Department of Environment, Health, and Natural 
Resources intends to amend rulefs) cited as ISA 
NCAC 13A .0001; 13B .0101, .0902 ■ 
.1204; ISA .2615; 19A .0102 - .0103. 
.0202, .0401; 20C .0002; 21A .0107; 25 
repeal rule(s) cited as 15 A NCAC I9D 
.0105, .0201 - .0204, .0301 - .0304, .0401 ■ 
19F .0101. .0/03 - .0105, .0201, .0203, 
.0305, .0401 - .0402; 20D .0201 - .0224, 
.0230; and adopt rule(s) cited as 15.4 NCAC 13B 
.1401 - .1409; 16 A .0901 - .0912; 19 A .0204 - 
.0205, .0213 - .0215; 20D .0231 - .0261. 

1 he proposed effective date of this action is De- 
cember 1 . 1991 . 



.0903. 
.0201 - 

.0213; 
.0101 - 
■ .0407; 
.0301 - 
.0226 - 



1 he public hearing will be conducted 



at: 



August 6, 1991 

7:00 p.m. 

A uditorium 

New Hanover Co. Health Dept. 

2029 South 17th Street 

Wilmington. NC 

August 9, 1991 

1 :30 p.m. 

Ground Floor Hearing Room 

Archdale Bui/ding 

512 North Salisbury Street 

Raleigh, NC 

August 12. 1991 

7:00 p.m. 

Room 204 

Buncombe Co. Courthouse 

60 Court Plaza 

Asheville, NC 

August 14, 1991 

7:00 p.m. 

Auditorium 

Forsyth-Stokes Mental Health Ctr. 

725 Highland Avenue 

Winston- Salem, NC 

(_ omment Procedures: All persons interested in 
these matters are invited to attend the public 
hearing. Written comments may be presented at 
the public hearing or submitted to John P. 
Barkley. DEHNR, P.O. Box 27687, Raleigh. NC 



27611-7687, (919) 733-7247. If you desire to 
speak at the public hearing, notify John P. Barkley 
at least three days prior to the public hearing. 
Oral presentation lengths may be limited depend- 
ing on the number of people that wish to speak at 
the public hearing. At the discretion of the 
Chairman, the public may also be allowed to 
comment on the rules at the Commission Meeting. 

y± fiscal note has been prepared and can be ob- 
tained from the agency for 15A NCAC 16 A .0901 



IMPORTANT THAT ALL IN- 

AND POTENTIALLY AF- 

PERSONS, GROUPS, 

A SSOCIA TIONS, INSTI- 



.09i: 

IT IS VERY 
TERESTED 
FECTED 
BUSINESSES. 
TUT IONS, OR AGENCIES MAKE THEIR 
VIEWS AND OPINIONS KNOWN TO THE 
COMMISSION FOR HEALTH SERVICES 
THROUGH THE PUBLIC HEARING AND 
COMMENT PROCESS. WHETHER THEY 
SUPPORT OR OPPOSE ANY OR ALL PRO- 
VISIONS OF THE PROPOSED RULES. THE 
COMMISSION FOR HEALTH SERVICES 
MAY ADOPT MORE OR LESS STRINGENT 
STANDARDS OR REQUIREMENTS THAT 
MAY DIFFER FROM THOSE BEING NO- 
TICED HEREIN, WITHOUT REN OTIC E OR 
REHEARING, IF THE COMMISSION FOR 
HEALTH SERVICES DETERMINES THAT 
THE FINAL ADOPTED RULES AREA LOG- 
ICAL OUTGROWTH OF THE NOTICE, 
PUBLIC HEARINGS AND THE HEARING 
COMMENTS RECEIVED. 

CHAPTER 13 -SOLID WASTE MANAGEMENT 

SUBCHAPTER I3A - HAZARDOUS WASTE 
MANAGEMENT 

.0001 GENERAL 

(b) In applying the federal requirements incor- 
porated by reference throughout this Subchapter, 
the following exceptions e* substitutions or ex- 
ceptions shall apply: 

( 1 ) "Department of Environment, Health, and 
Natural Resources" shall be substituted 
for "Environmental Protection Agency" 
except in 40 CFR 262.51 through 262.54. 
262.56. 262.57 where references to the 
Environmental Protection Agency shall 
remain without substitution; 

(2) "Secretary of the Department of Environ- 
ment. Health, and Natural Resources" 
shall be substituted for "Administrator," 
"Regional Administrator" and "Director" 
except for 40 CER 262.55 through 262.57. 



32' 



6:' 



NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



264.12(a), 268.5, 268.6, 268.42(b) and 
268.44 where the references to the Ad- 
ministrator, Regional Administrator, and 
Director shall remain without substi- 
tution; and 
(3) An "annual report" shall be required for 
all hazardous waste generators, treaters, 
storers, and disposers rather than a 
"biennial report". 

Statutory Authority G.S. 1 10 A- 294(c). 

SUBCHAPTER 13B - SOLID WASTE 
MANAGEMENT 

SECTION .0100 - GENERAL PROVISIONS 

.0101 DEFINITIONS 

The definitions in G.S. 130A-290 and the fol- 
lowing definitions shall apply throughout this 
Subchapter: 
(66) "Residues from Agricultural Products and 
Processing" means solids, semi-solids or liq- 
uid residues from food and beverage proc- 
essing and handling; silviculture; agriculture; 
and aquaculture operations that are non- 
toxic, non-hazardous, and contain no do- 
mestic wastewater. 



(67) "Municipal Solid Waste" means solid 
waste generated bv residences, stores, offices, 



restaurants, warehouses. 



other 



non- 



manufacturing activities, and industrial 
waste which is not a residue from a treat- 



ment or processing activity. 
(f'S) " 1 reatment and Processing Waste" means 
waste that is a residual solid from a 
wastewater treatment or pretreatment facil- 
ity 

(69) "Industrial Process Waste" means any 
solid, semi-solid, or liquid waste generated 
by a manufacturing or processing plant 
which is a result of the manufacturing or 
processing process. This definition does not 
include packaging materials associated with 
such activities. 

(70) "Mulch" means a protective covering of 
various substances, especially organic, to 
which no plant food has been added and for 
which no plant food is claimed. Mulch is 
generally placed around plants to prevent 
erosion, compaction, evaporation ' of 

of roots, and weed 



moisture 



growth. 



freezing 



which continued decomposition and stabili- 
zation occurs. 
(72) "Thermophilic Stage" means the stage of 
the composting process in which the rate of 
biological activity is sufficient to maintain 
an average pile temperature of at_ least 131 
degrees I-' (55 degrees C). Rapid destruction 
of pathogenic organisms occurs during this 
stage. This stage precedes the mesophilic 
stage. 



71) "Mesophilic Stage" means the stage of the 
composting process in which the rate of bi- 
ological activity is sufficient to maintain an 
average pile temperature of at least 90 de- 
grees F (32 degrees C). This stage follows 
the thermophilic stage and is the stage in .1204 REQUIREMENTS FOR GENERATORS 



(73) "Soil Scientist" means an individual who 
is a Certified Professional Soil Scientist or 
Soil Specialist by American Registry of 
Certified Professional in Agronomy, Crops, 
and Soils (ARCPACS) or an individual that 
demonstrates equivalent experience or edu- 
cation. 

Statutory Authority G.S. 130A-294. 

SECTION .0900 - YARD WASTE FACILITIES 

.0902 APPLICABILITY FOR YARD WASTE 
FACILITY 

As of January 1, 1993, disposal of yard trash in 
a sanitary landfill shall be prohibited; however, 
yard trash which has been separated may be ac- 
cepted at a sanitary landfill where the facility 
provides and maintains a separate yard waste 
composting area. 
(2) Activities not requiring a permit. A permit 
is not required for the following operations: 
(c) Facilities processing and storing less than 
6,000 cubic yards of material quarterly, 
meeting the following conditions: 
(ii) Agreement to operate in accordance 
with operational and siting requirements 
as set forth in Rule .0903 and Rule .0904 
of this Section, except for .0904(7). 

Statutory Authority G.S. 130A-309.10; 
130 A- 309.1 1. 

.0903 APPLICATION REQUIREMENTS FOR 
YARD WASTE FACILITIES 

(b) The following information shall be required 
for reviewing an application for a yard waste fa- 
cility: 

(4) An operational plan which contains the 
following: 
(C) Person responsible for operation, con- 
tact phone number, and address of facility; 

Statutory Authority G.S. 130A-309.il. 

SECTION .1200 - MEDICAL WASTE 
MANAGEMENT 



6:7 NORTH CAROLINA REGISTER July I, 1991 



328 



PROPOSED RULES 



OF REGL'LATF.D MEDICAL WASTE 

(a) A person who ships Regulated medical 
waste from the generating facility for off-site 
treatment shall meet the following requirements: 
(1) Regulated medical waste shall be packaged 
in a minimum of one plastic bag placed 
in a ngid fiberboard box or drum in a 
manner that prevents leakage of the con- 
tents. The plastic bag shall be impervious 
to moisture and have a strength sufficient 
to preclude ripping, tearing or bursting the 
waste-filled bag under normal conditions 
of usage and handling. Each bag shall be 
constructed of material of sufficient single 
thickness strength to pass the 165-gram 
dropped dart impact resistance test as 
prescribed by Standard D 1700 75 Stand- 
ard D 1709-91 of the American Society tor 
Testing and Materials, which is adopted 
by reference in accordance with G.S. 
150B- 14(c). and certified by the bag man- 
ufacturer. 

Statutory Authority G.S. J30A-309.26. 



comply with all other applicable Federal or state 
regulations regarding sludge management. 

(b) The provisions of this Rule do not apply 
to compost facilities operated in accordance with 
the requirements for Yard Waste Faculties in 
Section .0900 of this Subchapter. 

(c) Municipal Solid Waste Compost Facilities 
which have been permitted prior to the effective 
date of this Rule shall meet the requirements of 
this Rule by December 1, 1992. 

(d) Municipal solid waste compost products 
produced outside the State of North Carolina 
and imported into the state shall comply with the 
requirements specified in Rule .1407 of this Sec- 
tion. 

(e) Municipal solid waste compost shall count 
towards goals for the reduction of municipal solid 
waste prior to final disposal or incineration at a 
solid waste disposal facility as long as the final 
product is used or sold based upon the classi- 
fication and distribution scheme outlined in Rule 
.1407 of this Section. Compost which is dis- 
posed of shall not count toward reduction or re- 
cvcling eoals. 



SECTION .1400 - MUNICIPAL SOLID WASTE 
(MSW) COMPOST FACILITIES 

.1401 PROCEDURE FOR PERMIT 

(a) All persons whose purpose is or includes 
the production of compost from municipal solid 
waste or municipal solid waste co-composted 
with other wastes shall not construct, operate, 
expand or modify a facility until a currently valid 
permit for a municipal solid waste compost fa- 
cility is issued by the Division. Siting, design, 
application, operational, distribution, and re- 
porting requirements shall be in accordance with 
Rules .1403, .1404. .1405, .1406, .1407, and .1408 
of this Section. 

(b) In accordance with 15A NCAC 13B 
.0202(a)(3), the seal of a professional engineer is 
required when submitting plans for a Municipal 
Solid Waste Compost Facility Permit. A mini- 
mum of four sets of plans shall be submitted 
within each application. 

Statutory Authority G.S. 130A-309.il. 

.1402 GENERAL PROVISIONS FOR MSW 
COMPOST FACILITIES 

(a) Applicability. The provisions of this Rule 
apply to compost facilities which compost mu- 
nicipal solid waste or co-compost municipal solid 
waste with any of the following: treatment and 
processing wastes, yard waste, industrial process 
wastes, agricultural waste, residues from agricul- 
tural products and processing, or sludge func- 
tioning as a nitrosen source. Facilities shall 



Statutory Authority G.S. 130A-309.il. 

.1403 GENERAL PROHIBITIONS FOR MSW 
COMPOST FACILITIES 

(a) Hazardous waste, asbestos containing waste 
or household hazardous waste shall not be proc- 
essed into compost. 

(b) Any compost made from municipal solid 
waste which cannot be used pursuant to the re- 
quirements of this Rule shall be reprocessed or 
disposed of pursuant to the requirements of 15A 
NCAC 13B. 

Statutory Authority G.S. 130A-309.il. 

.1404 SITING/DESIGN REQUIREMENTS 
FOR MSW COMPOST FACILITIES 

Facilities shall comply with the following siting 
and design requirements: 
(1) A site shall meet the following siting re- 
quirements: 

(a) A site located in a floodplain shall not re- 
strict the flow of the 100-year flood, re- 
duce the temporary storage capacity of the 
floodplain or result in washout of solid 
waste so as to pose a hazard to human 
life, wildlife, land or water resources: 

(b) A 100-foot minimum buffer will be re- 
quired between all property lines and 
compost areas; 

(c) A 500-foot minimum buffer will be re- 
quired between compost areas and resi- 
dences or dwellings; 



329 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



(d) A 200-foot minimum buffer will be re- 
quired between perennial streams/rivers 
and compost areas; 

(e) A site shall not be located over a closed 
out disposal area; 

(f) A site shall meet the following surface wa- 
ter requirements: 

(i) A site shall not cause a discharge of 
materials or fill materials into waters or 
wetlands of the state that is in violation 
of Section 404 of the Clean Water Act; 

(ii) A site shall not cause a discharge of 
pollutants into waters of the state that is 
in violation of the requirements of the 
National Pollutant Discharge Elimination 
System (NPDES), under Section 402 of 
the Clean Water Act; and 

(iii) A site shall not cause non-point source 
pollution of waters of the state that vio- 
lates assigned water quality standards; 

(g) A site shall meet the following 
groundwater requirements: 

(i) A site shall not contravene groundwater 
standards as established under 15A 
NCAC 2L; and 

(ii) The bottom elevation of the composting 
and storage areas shall be a minimum of 
three feet above the seasonal high water 
table. 

(2) For Subparagraphs (l)(a) through (l)(d) 
of this Rule, alternative buffers for an indoor 
or enclosed vessel facility may be approved 
on a case-by-case basis. 

(3) A site shall meet the following design re- 
quirements: 

(a) A site shall not allow uncontrolled public 
access; 

(b) A site shall meet the requirements of the 
Sedimentation Pollution Control Law 
(15A NCAC 4); 

(c) A site shall meet the requirements of the 
Air Pollution Control Requirements (15A 
NCAC 2D) to ensure that all particulates 
remain on site; and 

(d) A site shall be operated as to prohibit 
nuisance odors at the property boundary. 

Statutory Authority G. S. 130A-309.U. 

.1405 APPLICATION REQUIREMENTS FOR 
MSW COMPOST FACILITIES 

This Rule contains the information required for 
a municipal solid waste compost facility. 

(1) The following information is required for 
reviewing an application for the initial per- 
mit to construct a proposed municipal solid 
waste compost facility: 



(a) An aerial photograph or scaled drawing, 
where one inch is less than or equal to 400 
feet, showing the area within one-fourth 
of the mile of the proposed site's bound- 
aries with the following specifically iden- 
tified: 

(i) Entire property owned or leased by the 

person proposing the site; 
(ii) Land use and zoning; 
(iii) Location of all homes, industrial 

buildings, public or private utilities and 

roads; 
(iv) Location of wells, watercourses, dry 

runs, and other applicable information 

regarding the general topography; 
(v) Floodplains and wetlands; and 
(vi) Bench marks. 

(b) A letter from the unit of government 
having zoning jurisdiction over the site 
which states that the proposal meets all 
of the requirements of the local zoning 
ordinance. 

(c) A discussion of compliance with all local, 
state, and Federal ordinances or permits 
required to fully comply with these Rules. 

(d) A discussion of compliance with siting and 
design standards in Rule .1404 Subpara- 
graphs (1) and (2) of this Section. 

(e) A detailed report indicating the following: 
(i) Population and geographic area to be 

served (both present and projected); 

(ii) Type, source and quantity of the solid 
waste to be composted, including the 
source and expected quantity of any 
bulking agent or amendment (if applica- 
ble), any expected recycle of bulking agent 
or compost, and any seasonal variations 
in the solid waste type or quantity; 

(iii) For systems which utilize an active 
composting and storage area less than two 
acres in size (excluding equipment storage 
areas), a soil evaluation of the site con- 
ducted by a soil scientist (or equivalent) 
down to a depth of seven feet to ade- 
quately evaluate the soils and depth of the 
seasonal high water table; 

(iv) For systems which utilize an active 
composting and storage area equal to or 
greater than two acres in size (excluding 
equipment storage areas), a geological and 
hydrological study of the site which pro- 
vides: 

(A) Soil borings (numbers and depths 
shall be confirmed by the Division) and 
lab testing of selected soils that provide: 

(I) Particle size analysis, 

(II) Soil classification - LSCS, 



6:7 NORTH CAROLINA REGISTER July I, 1991 



330 



PROPOSED RULES 



(B) Undisturbed representative geologic 
samples of the unconfined or confined 
or semiconfined hydrogeologic units 
within a depth of 20 feet that provides 
the following information: 

(I) Saturated hydraulic conductivity (or 
by in-situ), 

(II) Volume percent water, 

(III) Porosity, 

(C) Stratagraphic cross-sections identify- 
ing hydrogeological units including 
lithology, 

(D) A potentiometric map of the surficial 
aquifer based on stabilized water table 
elevations, 

(E) Boring logs, and 

(F) A report summarizing the geologic 
and hydrological evaluation; 

(v) The requirements of Subparagraphs 
(l)(e)(iv) of this Rule may be waived, if 
the composting site is to be located at a 
permitted sanitary landfill site, and the 
Division determines that sufficient 
hydrogeologic data has previously been 
submitted as part of the landfill permit. 

(f) Site plans at a scale where one inch is less 
than or equal to 200 feet (maximum five 
foot contours) to the inch that delineates 
the following: 

(i) Existing and proposed contours; 

(ii) Location and elevations of dikes, 
trenches, and other control devices and 
structures; 

(iii) Designated buffer zones and property 
lines; 

(iv) Diversion and controlled removal of 
surface water; 

(v) Proposed utilities and structures; 

(vi) Access roads, details on traffic patterns; 

(vii) Areas for unloading, processing, cur- 
ing, and storage of municipal solid waste 
compost; 

(viii) Areas for unloading, processing, and 
storing recyclables, household hazardous 
waste, and other materials, where appli- 
cable; 

(ix) Proposed surface and groundwater, 
monitoring locations; and 

(x) Direction of prevailing winds. 

(g) A description of the operation of the fa- 
cility, which must include at a minunum: 

(i) Estimated daily traffic flow to and from 

the facility; 
(ii) Procedure for unloading trucks; 
(iii) Arrangements for the operation of the 

facility; 
(iv) Identification of personnel and their 

responsibilities; 



(v) A schedule for operation, including the 
days and hours that the facility will be 
open, preparations before opening, and 
procedures followed after closing for the 
day; 

(vi) Plan for recycling a majority of the 
marketable recyclables in the waste 
stream; 

(vii) Plan for removing household hazard- 
ous waste in the waste stream; 

(viii) Special precautions or procedures for 
operating during wind, heavy rain, snow, 
freezing or other adverse conditions; 

(ix) A description of actions to be taken to 
minimize noise, vectors, air borne 
particulates, and odors; 

(x) A description of the ultimate use for the 
finished compost, method for removal 
from the site, and a plan for use or dis- 
posal of finished compost that cannot be 
used in the expected manner due to poor 
quality or change in market conditions; 
and 

(xi) A description of the label or other in- 
formation source that outlines the type of 
waste contributing to the compost, a list 
of projected restrictions on compost use, 
and projected recommended safe uses and 
application rates for the compost, 
(h) A report on the design of the facility, in- 
cluding: 

(i) A process flow diagram of the entire fa- 
cility, including all major equipment, the 
location of all temperature and all other 
monitoring points, and flow streams. The 
flow streams shall indicate the quantity of 
material on a wet weight, dry weight, and 
volumetric basis; 

(ii) A description and sizing of the storage 
facilities for amendment, bulking agent, 
solid waste, recyclables, household haz- 
ardous waste and finished compost; 

(hi) The technology for measuring, 

shredding, mixing, and proportioning in- 
put materials; 

(iv) The type, size, and associated detention 
time for the handling, processing, and 
storage equipment; 

(v) The separation, processing, storage, and 
ultimate disposal of non-compostable 
materials, if applicable; 

(vi) A description of the location of all 
temperature and any other type of moni- 
toring points, and the frequency of moni- 
toring; 

(vii) A description of how the temperature 
control and monitoring equipment will 
demonstrate that the facility qualifies as a 



331 



6:7 NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



process to further reduce pathogens as 
outlined in Rule .1406 Subparagraph 
(9)(b) of this Section; 

(viii) The aeration capacity of the system 
(for static pile and enclosed vessel sys- 
tems); 

(ix) The mass balance through the system; 

(x) The method of supplying and regulating 
air flow; 

(xi) A description of the air emission and 
control technologies; 

(xii) A description of the method to control 
surface water run-off; and the method to 
control, collect, treat, and dispose of 
leachate generated; 

(xiii) A description of any seed material, 
including its quantity, quality, and fre- 
quency of use; 

(xiv) If treatment and processing wastes, 
residues from agricultural products or 
processing, industrial process wastes, or 
sludges are to be composted: quantity, 
chemical and physical analysis, and rec- 
ommendations from the Division of En- 
vironmental Management shall be 
submitted with the application; and 

(xv) A description of any recycling or other 
material handling processes used at the 
facility, 
(i) Detailed engineering plans and specifica- 
tions for the entire facility, including 
manufacturer's performance data for all 
equipment selected. 
(2) The following information is required for 

reviewing an application to operate a mu- 
nicipal solid waste composting facility: 

(a) Contingency plans detailing corrective or 
remedial action to be taken in the event 
of equipment breakdown; air pollution; 
non-conforming waste delivered to the fa- 
cility; spills, and undesirable conditions 
such as fires, particulates, noise, vectors, 
odors, and unusual traffic conditions; 

(b) .An operation and maintenance manual. 
The manual must contain general design 
information, a discussion of compliance 
with operational requirements as outlined 
in Rule .1406 of this Section, detailed op- 
erational information and instruction, 
equipment maintenance, list of personnel, 
required personnel training, and safety in- 
structions; 

(c) A quality assurance plan for the final 
product which lists the procedures used in 
monitoring, sampling and analyzing the 
compost product, and record keeping re- 
quirements; 



(d) A fact sheet and process flow diagram that 
summarizes actual equipment sizing, 
aeration capacity, detention times, storage 
capacity, and flow rates (wet weight, dry 
weight, and volumetric) for the system 
and equipment chosen; 

(e) As-built drawings; and 

(f) A copy of all applicable local, state, and 
Federal permits and approvals necessary 
for the proper operation of the facility. 

Statutory Authority G.S. B0A-309.ll. 

.1406 OPERATIONAL REQUIREMENTS FOR 
MSVV COMPOST FACILITIES 

Any person who maintains or operates a mu- 
nicipal solid waste compost facility shall maintain 
and operate the site to conform with the follow- 
ing practices: 

(1) Plan and Permit Requirements: 

(a) Construction plans shall be approved and 
followed. 

(b) A copy of the permit, plans, and opera- 
tional reports shall be maintained on site 
at all times. 

(2) Erosion Control Requirements: 

(a) Adequate erosion control measures shall 
be practiced to prevent silt from leaving 
the site. 

(b) Adequate erosion control measures shall 
be practiced to prevent excessive on-site 
erosion. 

(3) Surface water shall be diverted from the 
operational, compost curing, and storage 
areas. 

(4) Leachate shall be contained on site or 
properly treated prior to disposal. 

(5) Access and Security Requirements: 

(a) The site shall be secured by means of 
gates, chains, berms, fences, or other se- 
curity measures approved by the Division, 
to prevent unauthorized entry. 

(b) An operator shall be on duty at the site 
at all times while the facility is open for 
public use to ensure compliance with op- 
erational requirements. 

(c) The access road to the site shall be of all- 
weather construction and maintained in 
good condition. 

(6) Waste Acceptance: 

(a) A site shall only accept those solid wastes 
which it is permitted to receive. 

(b) No hazardous waste, asbestos containing 
waste, or medical waste shall be accepted 
at the facility. 

(7) Safety Requirements: 

(a) Open burning of solid waste is prohibited. 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



332 



PROPOSED RULES 



(b) Fquipment shall be provided to control 
accidental fires or arrangements made 
with the local fire protection agency to 
immediately provide fire-fighting services 
when needed. 

Personnel training shall be provided to 
insure that all employees are trained in site 
specific safety, remedial, and corrective 
action procedures. 
Sign Requirements: 

Signs providing information on dumping 
procedures, the hours during which the 
site is open for public use, the permit 
number and other pertinent information 
shall be posted at the site entrance. 
Traffic signs markers shall be provided as 
necessary to promote an orderly traffic 
pattern to and from discharge area and to 
maintain efficient operating conditions. 
Signs shall be posted stating that no haz- 
ardous waste, liquid waste, asbestos con- 
taining waste, or medical waste can be 
received at the site. 
Monitoring Requirements: 

Specified monitoring and reporting re- 
quirements shall be met. 
The composting process shall qualify as a 
process to further reduce pathogens. The 
following are acceptable methods: 

(i) The windrow method for reducing 
pathogens consists of an unconfincd 
composting process involving periodic 
aeration and mixing. Aerobic conditions 
must be maintained during the compost 
process. A temperature of 131 degrees F 
(55 degrees Celsius) must be maintained 
in the windrow for at least three weeks. 
The windrow must be turned at least 
twice during every six to ten day period. 

(ii) The static aerated pile method for re- 
ducing pathogens consists of an uncon- 
fined composting process involving 
mechanical aeration of insulated compost 
piles. Aerobic conditions must be main- 
tained during the compost process. The 
temperature of the compost pile must be 
maintained at 131 degrees F (55 degrees 
Celsius) for at least seven davs. 



(c) 



(8) 

(a) 



(b) 



(c) 



(9) 
(a) 

(b) 



(O 



(10) 
(a) 



(b) 



(c) 



(d) 



(e 



(0 



(iii) The enclosed vessel method for reduc- 
ing pathogens consists of a confined 
compost process involving mechanical 
mixing of compost under controlled envi- 
ronmental conditions. The retention time 
in the vessel must be at least 24 hours 
with the temperature maintained at 131 
degrees F (55 degrees Celsius). A stabili- 
zation period of at least seven days must 
follow the minimum 24 hour decompos- 
ition period. Temperature in the compost 
pile must be maintained at a minimal 
temperature of 131 degrees F (55 degrees 
Celsius) for three days during the stabili- 
zation period. 

The temperature of each daily batch of 
compost produced shall be monitored 
sufficiently to ensure that the pathogen 
reduction criteria is met. 
Miscellaneous Requirements: 

The waste storage area and the active 
composting, curing, and compost storage 
areas shall be located on surfaces capable 
of minimizing releases to the surface im- 
mediately below these areas, to the sur- 
rounding land surface, and groundwater. 
If natural soils are used, the liner must be 
at least 18 inches thick and the liner coef- 
ficient of permeability must not be greater 
than 1 x 1 0(-7) centimeters per second. 
The finished compost shall meet the clas- 
sification and distribution requirements 
outlined in Rule .1407 of this Section. 
The quality of the final product will de- 
termine the allowable uses as outlined in 
Rule .1407 of this Section. 
The final product shall be approved by the 
Solid Waste Section (based upon the 
classification and distribution scheme and 
testing results). 

Non-compostable solid waste and unac- 
ceptable compost shall be disposed of in 
a manner approved by the Division. 
The amount of compost stored at the fa- 
cility shall not exceed the designed storage 
capacity. 



Statutory Authority G.S. 130A-309.1 1 . 



.1407 CLASSIFICATION/DISTRIBUTION OF MSW COWOST PRODI CTS 

Municipal solid waste compost shall be classified based on its physical and chemical properties, and 
degree of stabilization. 



333 



6:7 NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



(1) Maximum allowable physical characteristics of marketable grades shall be as designated in Table 
1: 





TABLE 


1 


GRADE 


PARTICLE SIZE 

(inches) 


FOREIGN MATTER 

% of dry Wt. Inert s 


Fine 

Medium 

Coarse 


.25 

.50 

1.00 


1.5 

3.0 
6.0 



(2) Maximum allowable chemical characteristics codes of marketable grades shall be as designated in 
Table 2: 

TABLE 2 



PARAMETER 


CODE 


CODE 


CODE 


(mg/kg dry wt.) 


1 


2 


3 


Mercury 


10 


10 


10 


Cadmium 


10 


15 


25 


Nickel 


100 


200 


500 


Copper 


600 


600 


1000 


Lead 


250 


500 


1000 


Chromium 


1000 


1000 


1000 


Zinc 


1000 


2000 


2500 


Total PCB's 


1 


1 


10 



(3) Degree of stabilization of marketable grades shall be as designated in Table 3: 
(a) Table 3: 

TABLE 3 



DEGREE 


STAGE 


MEETS 


ROM 


RE-HEAT 


Fresh 

Semi -mature 

Mature 


Passed through 
first thermophilic 
In mesophilic 

Through both 


PFRP 
PFRP 
PFRP 


40 % 
50 % 


No 

Requirements 

No 

Requirements 

Yes, see Subparagraph 

(3)(c) of this Rule 



(b) 'ROM" means reduction in organic matter. 



6:7 NORTH CAROLINA REGISTER July I, 1991 



334 



PROPOSED RULES 



(c) Mature compost cannot reheat to greater than 20 degrees Celsius above ambient temperature. 

(4) Final grades for distribution and marketing of compost shall be based upon Table 1 thru Table 
3 and shall be as follows: 

(a) Retail Grade shall have the following qualities: 

(i) Fine grade compost as denoted in Subparagraph (1) of this Rule; 
(ii) Chemical characteristics Code 1 as denoted in Subparagraph (2) of this Rule; 
(iii) Mature degree of stabilization as denoted in Subparagraph (3) of this Rule; and 
(iv) Soluble salts less than 10 millimhos, centimeter (dry weight basis). 

(b) Commercial Grade shall have the following qualities: 

(i) Line or medium grade compost as denoted in Subparagraph ( 1) of this Rule; 

(ii) Chemical characteristics Code 1 or 2 as denoted in Subparagraph (2) of this Rule; 

(iii) Mature or semi-mature degree of stabilization as denoted in Subparagraph (3) of this Rule; 

and 
(iv) Soluble salts less than 10 millimhos centimeter (dry weight basis). 

(c) Land Application Grade shall have the following qualities: 

(i) Fine, medium or coarse grade compost as denoted in Subparagraph (1) of this Rule; 

(ii) Chemical characteristics Codes 1. 2, or 3 as denoted in Subparagraph (2) of this Rule; 

(iii) Mature, semi-mature, or fresh degree of stabilization as denoted in Subparagraph (3) of this 

Rule: and 
(iv) Soluble salts less than 10 milhmhos centimeter (dry weight basis). 

(5) For applications where repeated use of the compost can be expected, such as in agricultural ap- 
plications, the maximum accumulation of heavy metal applied to the soils shall be as designated 
in Table 4: 



FABLE 4 



Range of Cation Exchange Capacity of Soil (CFC) 


(CEC) 


1 - 5 


6- 10 


11-15 


> 15 


Maximum Cumulative Loading Rate (lbs acre) 


HEAVY 
METAL 

Lead 

Zinc 

Copper 

Nickel 

Cadmium 


65 

50 

25 

25 
2 


125 
75 
45 
45 
3 


250 

125 

65 

65 

4 


500 
250 
125 
125 
5 



The Cation Exchange Capacity may be determined by procedures accepted by the North Carolina 
Department of Agriculture or EPA test method 90S1. 
(6) Distribution of the defined grades shall be as follows: 

(a) Grades: 

(i) Retail Grade Compost shall have unlimited, unrestricted distribution (bagged or bulk). 

(ii) Commercial Grade Compost shall be restricted to distribution to commercial, agricultural. 

or governmental operations; however, such use shall not be allowed if contact with the general 

public is expected. 
(iii) Fand Application Grade shall be restricted to distribution for land and mine reclamation, 

silviculture, and agriculture (on non-food chain crops) projects. 

(b) Municipal solid waste compost products may not be distributed or marketed until the permittee 
has provided adequate test data to the Division as outlined in Rule . 140S of this Section. Within 
30 days of receipt of the test data, the Division shall approve or deny the distribution and mar- 
keting of the product based upon the compost classification and distribution scheme. 



335 



6:~ \ORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



(c) If the owner intends to market the product as a fertilizer, the applicant must register with the 
North Carolina Department of Agriculture, Fertilizer Section. The product must meet the 
NCDA's minimal nutrient requirements. 

(d) If the owner intends to market the product as a mulch, the owner must provide instructions to 
the user on any restrictions on use and recommended safe uses and application rates. The fol- 
lowing information must be provided on a label: 

(i) Percent moisture content; 

(ii) Classification grade as outlined in this Rule; 

(iii) Recommended uses; 

(iv) Application rates; 

(v) Calcium Carbonate equivalent (for products which have been lime stabilized); and 

(vi) Restrictions on usage. 

(e) If the owner intends to use the final product for land application projects, he shall comply with 
all local, state, and Federal rules and regulations concerning land application. 

Statutory Authority G.S. I30A-309.il. 

.1408 METHODS FOR TESTING AND REPORTING REQUIREMENTS 

The intent of this Rule is to define the methods and requirements for measuring and reporting the 
chemical and physical characteristics of the final compost product. 
(1) The compost product shall be sampled and analyzed as follows: 
(a) A composite sample of the compost produced at each compost facility shall be analyzed at in- 
tervals of every 20,000 tons of compost produced or every three months, whichever comes first, 
for parameters as designated in Table 5: 

TABLE 5 



PARAMETER 


UNIT 


METHOD 


Moisture 


% 


EPA 160.3 


Reduction in 






Organic Matter 


% 


EPA 160.4 


Organic Matter 


% 


EPA 160.4 


Foreign Matter 


0/ 

/o 


see Subparagraph (d) of 
this Rule 


Cadmium 


mg/'kg dry wt. 


EPA 3050/7130 


Copper 


mg/kg dry wt. 


EPA 3050/7210 


Lead 


mg kg dry wt. 


EPA 3050/7420 


Nickel 


mg/kg dry wt. 


EPA 3050/7520 


Zinc 


mg/kg dry wt. 


EPA 3050/7950 


Chromium 


mg/kg dry wt. 


EPA 3050/7140 


Mercury 


mg'kg dry wt. 


EPA 3050/7471 


Fecal Coliform 


//organisms/ 100ml 


Standard 9222 


Soluble Salts 


millimhos, cm 


Solubridge 1:2 ratio 


PCB's 


mg'kg dry wt. 


EPA 8080 


P II 


standard 


EPA 9045 



The parameters listed in Table 5 of this Rule may also be determined by methods accepted by 
the North Carolina Department of Agriculture. 
(b) Sample collection, preservation, and analysis shall assure valid and representative results pursu- 
ant to a Division-approved quality assurance plan. At least three individual samples (of equal 
volume) shall be taken from each batch produced in separate areas along the side of the batch. 
Each sampling point shall be at a depth of two feet into the pile from the outside surface of the 
pile. Samples shall be composited and accumulated over a three month period or at intervals 
of every 20,000 tons or product produced, whichever comes first. 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



336 



PROPOSED RULES 



(c) The Division may decrease or increase the parameters to be analyzed or the frequency of analysis 
based on monitoring date, changes in the waste stream or processing, or the potential presence 
of toxic substances. 

(d) Foreign matter content shall be determined by passing a dried, weighed sample of the compost 
product through a one-eighth inch screen. EPA Method 160.3 shall be used to dry the sample. 
The material remaining on the screen shall be visually inspected, and the foreign matter that can 
be clearly identified shall be separated and weighed. The weight of the separated foreign matter 
divided by the weight of the total sample shall be determined and multiplied by 100. This shall 
be the percent dry weight of the foreign matter content. 

(e) A composite, heterogeneous sample of the incoming waste stream (feedstock), which has been 
shredded or otherwise reduced in particle size, shall be used for determination of the initial or- 
ganic matter (0\1) used in the calculation for percent reduction in organic matter (% ROM). 
The organic matter content of this composite sample is determined by measuring the volatile 
solids content using EPA Method 160.4. 

(f) The reduction in organic matter is determined by comparing the organic matter content of the 
feedstock into the composting process and the organic matter content of the compost product 
(using EPA Method 160.4). The amount of reduction is determined as a percent of the original 
amount contained in the feedstock using the following calculation: 

% ROM = 100 [ 1 - (OMK(IOO-OM) OM(IOO-OMK)) j 

where. % ROM = percent reduction in organic matter. OM = percent organic matter of the 
feedstock, and OMK = percent organic matter of compost product. 

(2) Record Keeping: Facility owners or operators shall record and maintain, for a minimum of three 
years, the following information regarding their activities for each month of operation of the facil- 
ity. Records shall be available for inspection by Division personnel during normal business hours 
and shall be sent to the Division upon request. 

(a) Daily operational records must be maintained, which include, at a minimum, temperature data 
(length of the composting period) and quantity of material processed; 

(b) Analytical results on compost testing; 

(c) The quantity, type and source of waste received; 

(d) The quantity and type of waste processed into compost; 

(e) The quantity and type of compost produced by product classification; and 

(f) The quantity and type of compost removed for use or disposal, by product classification, and the 

market or permitted disposal facility. 

(3) Annual Reporting: An annual report shall be submitted to the Division which contains: 

(a) The facility name, address, and permit number; 

(b) The year covered; 

(c) The total quantity in tons, with sludge values expressed in dry weight, and type of waste received 
at the facility during the year covered by the report, including tons of waste received from local 
governments of origin; 

(d) The total quantity in tons, with sludge values expressed in dry weight, and type of waste proc- 
essed into compost during the year covered by the report; 

(e) The total quantity in tons and type of compost produced at the facility, by product classification, 
during the year covered by the report: 

(f) The total quantity in tons and type of compost removed for use or disposal from the facility, by 

product classification, along with a general description of the market if for use during the year 
covered by the report: 

(g) The total quantity in tons, and the type of waste removed from the facility and disposed of; 

(h) Condensed monthly temperature monitoring to support Rule .1406 Subparagraph (9)(c) of this 

Section; and 
(i) Condensed yearly totals of solid waste received and composted shall be reported back to the local 

government of origin for respective annual recycling reporting. 

Statutory Authority G.S. I30A-309.il. 

.1409 APPROVAL OF ALTERNATIVE (a) The owner or operator of a composting fa- 

PROCEDLRES AND REQL IREMENTS ci]:lty SUD ject to the provisions of this Rule, may 



337 6:7 NORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



request in writing the approval of an alternative 
procedure for the facility or the compost that is 
produced. The following information shall be 
submitted to the Solid Waste Section: 

(1) The specific facility for which the excep- 
tion is requested; 

(2) The specific provisions of this Section for 
which the exception is requested; 

(3) The basis for the exception; 

(4) The alternate procedure or requirement for 
which the approval is sought and a dem- 
onstration that the alternate procedure or 
requirement provides equivalent pro- 
tection of the public health and the envi- 
ronment; and 

(5) A demonstration of the effectiveness of the 
proposed alternate procedure. 

(b) An individual may request in writing the 
approval of a municipal solid waste composting 
pilot or demonstration project for the purpose 
of evaluating the feasibility of such a project. 
The following information shall be submitted to 
the Solid Waste Section: 

(1) The owner, operator, location, and contact 
numbers for the project; 

(2) The specific waste stream for which the 
project is to evaluate; 

(3) The specific time frame for the project; 

(4) The specific amount of waste to be 
composted; 

(5) The basis for running the pilot or demon- 
stration project; 

(6) A description of all testing procedures to 
be used; 

(7) A description of the process to be used and 
the expected final usage or disposal of the 
fmal product; and 

(8) An outline of the fmal report to be sub- 
mitted to the Solid Waste Section upon 
completion of the project. 

(c) For Paragraph (a) of this Rule, the Division 
will review alternative procedures only to the ex- 
tent that adequate staffing is available. 

Statutory Authority G.S. 130A-309.il. 

CHAPTER 16 - ADLLT HEALTH 

SUBCHAPTER I6A - CHRONIC DISEASE 

SECTION .0900 - RYAN WHITE HIV CARE 
PROGRAM 



Statutory Authority G.S. 130A-223. 

.0902 DEFINITIONS 

The following definitions shall apply through- 
out this Section: 

(1) "Care Consortium" is an association of one 
or more public, and one or more nonprofit 
private health care and support services 
providers or community based organizations 
operating within areas determined by the 
RWCP to be most affected by HIV disease. 

(2) "Essential Health Services" means services 
such as case management services; medical, 
nursing, and dental care; diagnostics; moni- 
toring; medical follow-up services; mental 
health; developmental and rehabilitation 
services; home health; and hospice care. 

(3) "Essential Support Services" means services 
such as transportation services; attendant 
care; homemaker services; day or respite 
care; benefits advocacy; advocacy services 
provided through public and nonprofit pri- 
vate entities; nutrition services; housing re- 
ferral services; child welfare and family 
services (including foster care and adoption 
services); and provision of information and 
counseling on living with HIV disease. 

(4) "Lead Agency" means the agency, organ- 
ization, institution or other entity which will 
assume administrative and fiscal responsibil- 
ity for RWCP Care Consortium Funds. 

(5) "RWCP Reimbursement Rate" is the: 

(a) maximum Medicaid rate, if one exists, for 
essential health services and essential sup- 
port services other than those set out in 
Paragraph (5)(b) and (c) of this Rule; 

(b) interim Medicare rate for medical social 
services; or 

(c) schedule of payments that shall be devel- 
oped by the Division of Adult Health for 
essential health services and essential sup- 
port services other than those set out in 
Paragraph (5)(a) and (b) of this Rule. 

(6) "Third Party Payor" is any person or entity 
that is or may be indirectly liable for the cost 
of services furnished to an eligible person. 
Third party payors include, without limita- 
tion, Medicaid, Medicare, and private insur- 
ance. 



.0901 GENERAL 

The Ryan White HIV Care Program (RWCP) 
is administered by the Health Care Section, Di- 
vision of Adult Health, Department of Environ- 
ment, Health, and Natural Resources, P.O. Box 
27687, Raleigh, NC 27611-7687. 



Statutory Authority G.S. 130.4-223. 

.0903 ELIGIBLE PROVIDERS 
(a) The RWCP may contract with a care con- 
sortium or a lead agency designated by a care 
consortium to provide essential health services 



6:7 NORTH CAROLINA REGISTER July I, 1991 



3.hS 



PROPOSED RULES 



and essential support services for individuals with 
HIV disease. 

(b) The RWCP may contract with public and 
private organizations, institutions, agencies, and 
individuals in order to carry out the RWCP. 

(c) Contracts may be renewed on an annual 
basis upon determination by the RWCP of a 
continuing need for essential health and essential 
support services in the care consortium service 
area; the performance of the care consortium, the 
need for services in other areas of the state, and 
the availability of funds. 

Statutory Authority G.S. I30A-223. 

.0904 APPLICATIONS FOR RWCP CARE 
CONSORTIUM FUNDS 

A care consortium interested in contracting for 
essential health services and essential support 
services must submit an application to the 
RWCP. The application shall include doc- 
umentation that the consortium: 

( 1 ) consists of one or more public and one or 
more nonprofit private health care and sup- 
port service providers or community-based 
organizations which: 

(a) operate within counties in North Carolina 
affected by HIV; 

(b) represent populations and subpopulations 
reflecting the local incidence of HIV; and 

(c) have a record of service to populations and 

subpopulations with HIV; 

(2) has consulted with the following entities in 
establishing a plan for the provision of es- 
sential health and essential support services: 

(a) public health agencies that provide or 
support ambulatory and outpatient 
IHV-relatcd health care services within the 
geographic areas to be served; 

(b) other entity or entities that directly provide 
ambulatory and outpatient IHV-related 
health care services within the geographic 
areas to be served; and 

(c) community-based organizations that exist 
solely for the purpose of providing 
HIV-related support services to individ- 
uals with HIV disease; 

(3) has conducted a needs assessment of the 
geographic area to be served and has devel- 
oped a plan to institute a comprehensive 
continuum of services to meet the identified 
needs; 

(4) has included persons with HIV disease in 
the needs assessment and planning stages of 
the consortium's plan; 

(5) has the capacity to coordinate, integrate 
and expand existing services; 



(6) will develop a mechanism to ensure conti- 
nuity of services through effective case man- 
agement; 

(7) can provide services which are cost effec- 
tive alternatives to hospitalization; 

(8) will spend at least 15 percent of their 
funding to provide health and/or support 
services to infants, children, women and 
families with HIV disease; 

(9) has developed a plan for outreach to rural 
areas, low income individuals and families 
with HIV disease, as well as to special sub- 
populations at high risk for HIV infection 
including but not limited to, injecting drug 
users and their partners, gay and bisexual 
men, homeless people, and children and ad- 
olescents at risk for HIV infection; 

(10) will comply with the North Carolina 
confidentiality laws; 

(11) has created a mechanism to evaluate on a 
periodic basis the success of the consortium 
in responding to identified needs and the 
cost effectiveness of the mechanism em- 
ployed by the consortium to deliver com- 
prehensive care. 

Statutory Authority G.S. I30A-223. 

.0905 FINANCIAL ELIGIBILITY 

All persons with HIV disease are financially eli- 
gible to receive RWCP essential health services 
and essential support services. 

Statutory Authority G.S. I30A-223. 

.0906 MEDICAL ELIGIBILITY 

A person who is determined by a health care 
professional to have HIV disease and who is de- 
termined to need essential health services or es- 
sential support services is eligible for RWCP 
services. 

Statutory Authority G.S. I30A-223. 

.0907 BILLING THE RYAN WHITE HIV 
CARE PROGRAM 

(a) If an eligible person's individual family an- 
nual gross income is 100 percent or below the 
official Federal Poverty Guidelines, the care 
consortium may bill the RWCP the RWCP Re- 
imbursement Rate. The care consortium must 
assure that an eligible person in this income cat- 
egory is not billed. 

(b) If an eligible person's individual family an- 
nual gross income is greater than 100 percent of 
the Federal Poverty Guidelines, the care consor- 
tium may bill the RWCP as follows: 



339 



6:7 NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



(1) 85 percent of the RWCP Reimbursement 
Rate if the eligible person's gross annual 
income is between or includes 101 percent 
and 130 percent of Federal Poverty 
Guidelines; 

(2) 70 percent of the RWCP Reimbursement 
Rate if the eligible person's gross annual 
income is between or includes 131 percent 
and 160 percent of Federal Poverty 
Guidelines; 

(3) 55 percent of the RWCP Reimbursement 
Rate if the eligible person's gross annual 
income is between or includes 161 percent 
and 190 percent of Federal Poverty 
Guidelines; 

(4) 40 percent of the RWCP Reimbursement 
Rate if the eligible person's gross annual 
income is between or includes 191 percent 
and 220 percent of Federal Poverty 
Guidelines; or 

(5) 25 percent of the RWCP Reimbursement 
Rate if the eligible person's gross annual 
income is equal to or greater than 221 
percent of Federal Poverty Guidelines. 

(c) An eligible person may be billed for essen- 
tial health and support services subject to the 
limitations as set forth in Rule .0908 of this Sec- 
tion. 

Statutory Authority G.S. I30A-223. 

.0908 LIMITATIONS ON FEE CHARGES 

(a) Individual and aggregate fee charges to eli- 
gible persons receiving essential health and es- 
sential support services or any other Ryan White 
C.A.R.E. Act services must conform to the fol- 
lowing limitations: 

( 1 ) If individual/family annual gross income 
is equal to or below 100 percent of the 
official Federal Poverty Guidelines, there 
shall be no charge. 

(2) If individual, family annual gross income 
is equal to 101 to 200 percent of the offi- 
cial Federal Poverty Guidelines, then the 
total allowable annual charges shall be five 
percent or less of the gross income level. 

(3) If individual, family annual gross income 
is 201 to 300 percent of the official Federal 
Poverty Guidelines, then the total allow- 
able annual charges shall be seven percent 
or less of the gross income level. 

(4) If individual/family annual gross income 
is more than 300 percent of the official 
Federal Poverty Guidelines, then the total 
allowable annual charges shall be 10 per- 
cent or less of the gross income level. 

(b) Once the total allowable annual charges to 
an individual, family under the entire Rvan White 



C.A.R.E. Act meet the limitations as set forth in 
this Rule, the individual/family may no longer 
be charged for RWCP essential health and es- 
sential support services. The care consortium 
may then bill the RWCP the full RWCP Re- 
imbursement Rate. 

(c) Individual/family annual gross income shall 
be determined by the care consortium by a signed 
declaration of gross income and family size by 
the medically eligible person or a person respon- 
sible for the eligible person. 

(d) Once a person's financial status is deter- 
mined for the purpose of assessing fee charges, 
the determination shall continue for the duration 
of the care episode, up to a maximum of one 
year. 

(e) The care consortium shall document each 
eligible person's financial status determination on 
a form provided by the RWCP. 

(f) The care consortium shall document indi- 
vidual and aggregate annual fees charged to an 
eligible person on a form provided by the pro- 
gram. 

Statutory Authority G.S. J 30 A- 223. 

.0909 RATES OF REIMBURSEMENT 

(a) Care consortia that contract for reimburse- 
ment funds shall be reimbursed for essential 
health services and essential support services 
provided to eligible persons in an amount and 
percentage based on the RWCP Reimbursement 
Rate in effect at the time service is rendered, as 
specified in Rule .0902(4) of this Section. 

(b) Claims for reimbursement from the RWCP 
must be documented and reported on a quarterly 
basis on a form provided by the program. No 
claims for reimbursement will be accepted by the 
RWCP more than 180 days after the date of de- 
livery of services. If after charging the program, 
the care consortium receives payment from the 
eligible person or other third party that would 
result in the care consortium receiving more than 
the RWCP Reimbursement Rate, the consor- 
tium shall reimburse the RWCP the difference 
between the total amount reimbursed from all 
sources and the RWCP Reimbursement Rate. 

Statutory Authority G.S. I30A-223. 

.0910 REIMBURSEMENT FUNDS: THIRD 
PARTY PAYORS 

RWCP reimbursement funds shall be used to 
pay for services not reimbursed by a third party 
payor. A contracting care consortium must take 
reasonable measures to determine and subse- 
quently collect the full legal liability of third party 
payors to pay for services reimbursed by the 



6:7 NORTH CAROLINA REGISTER July I, 1991 



340 



PROPOSED RULES 



program before requesting payment from the 
RWCP. 

Statutory Authority G.S. 130A-223. 

.0911 MONITORING 

Each care consortium receiving reimbursement 
funds shall submit the following information in 
a form as prescribed by and in the time frames 
established in the contract: 



(1) 
(2) 
(3) 
(4) 



RWCP quarterly report; 
RWCP annual report; 
Quarterly expenditure report; 
Other information necessary for the effec- 
tive administration of RYVC Program. 



Statutory Authority G.S. I30A-223. 

.0912 AUDITS 

Agency fmancial and statistical records, patient 
records, and any other pertinent information may 
be audited by the state as part of the overall 
monitoring and evaluation effort. 

Statutory Authority G.S. 130A-223. 

CHAPTER 18 - ENVIRONMENTAL HEALTH 

SUBCHAPTER I8A - SANITATION 

SECTION .2600 - SANITATION OF 

RESTAURANTS AND OTHER 

FOODHANDLING ESTABLISHMENTS 

.2615 MILK AND MILK PRODUCTS 

(a) Only Grade "A" pasteurized milk and milk 
products shall be used. The term "milk 
products" means those products as defined in 
15A NCAC 18A .1200. Copies of 15A NCAC 
18A .1200 may be obtained from the Department 
of Environment, Health, and Natural Resources, 
P.O. Box 27687, Raleigh, North Carolina 
27611-7687. Milk and milk products shall be 
served in the individual, original containers in 
which they were received from the distributor. 
However, approved sanitary bulk milk dispensers 
may be used and buttermilk may be poured only 
Irom a commercially tilled container of not more 
than I 2 gallon capacity. 

(b) An exception may be made in the case of 
cream served with coffee, cereals, etc., as the dis- 
tributor cannot deliver cream in the unit sizes 
that would be required. For such service, trans- 
ferring to individual service units from the ori- 
ginal container of not more than one-half gallon 
capacity, or from pumps, or other approved 
dispensers is permissible. The mixing of cream 
and milk or the pouring of either into jars, bot- 



tles, or other containers for storage therein shall 
be prohibited. 

(c) Bulk milk dispenser containers, as received 
from the distributor, shall be properly sealed, la- 
beled with the name and grade of the contents 
and identity of the distributor. Only the outlet 
seal shall be broken in the establishment. 

(d) Milk and milk products shall be stored in 
a sanitary manner and shall be kept refrigerated, 
except when being served. Milk containers shall 
not be completely submerged in water. 

(e) Reconstituted dry milk and dry milk pro- 
ducts may be used in instant desserts and 
whipped products, or for cooking and baking 
purposes. 

Statutory Authority G.S. 130A-248. 

CHAPTER 19 - HEALTH: EPIDEMIOLOGY 

SUBCHAPTER 19A - ACUTE COMMUNICABLE 
DISEASE CONTROL 

SECTION .0100 - REPORTING OF 
COMMUNICABLE DISEASES 

.0102 METHOD OF REPORTING 

(a) When a report of a disease or condition is 
required to be made pursuant to G.S. 130A-135 
through 139 and 15A NCAC 19A .0101, the re- 
port shall be made to the local health director as 
follows: 

(1) For diseases and conditions required to 
be reported within 24 hours, the initial 
report shall be made by telephone, and 
the report required by Paragraph (2) shall 
be made within seven days. 

(2) In addition to the requirements of Para- 
graph (1), the report shall be made on the 
communicable disease report card pro- 
vided by the Division of Epidemiology 
and shall include the name and address of 
the patient, the name and address of any 
minor's parent or guardian, and all other 
pertinent epidemiologic information re- 
quested on the form. 

(3) Until September 1, 1994, reports of cases 
of confirmed HIV infection identified by 
anonymous tests that are conducted at 
HIV testing sites designated by the State 
Health Director pursuant to 44A NCAC 
44A .0201(d)(10) 15A NCAC 19A 
,0202( 10) shall be made on forms pro- 
vided by the Department for that purpose. 
No communicable disease report card 
shall be required. Effective September 1, 
1994, anonymous testing shall be discon- 
tinued and all cases of confirmed HIV in- 



341 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



PROPOSED RULES 



fection shall be reported in accordance 
with 15A NCAC 19A .0102(a)(1) and (2). 

(4) In addition to the requirements of Para- 
graph (1) and (2), the epidemiologic in- 
formation requested on a surveillance 
form provided by the Division of 
Epidemiology' shall be completed and 
submitted for the reportable diseases and 
conditions identified in 15A NCAC 19A 
.0101 (1), (6), (17), (18), (19), (20), (21), 
(23), (24), (25), (26), (28), (29), (30), (32), 
(33), (34), (37), (38), (41), (42), (43), (44), 
(48), (49), (50), (51), (52), (53), (54), and 
(56). 

(5) Communicable disease report cards and 
surveillance forms are available from the 
morbidity unit, N.C. Division of 
Epidemiology, P.O. Box 27687, Raleigh, 
N.C. 27611, and from local health de- 
partments. 

(b) Notwithstanding the time frames estab- 
lished in Rule .0101, a restaurant or other food 
or drink establishment is required to report all 
outbreaks or suspected outbreaks of foodbome 
illness in its customers or employees and all sus- 
pected cases of foodborne disease or foodborne 
condition in food-handlers at the establishment 
by telephone to the local health department 
within 24 hours in accordance with Paragraph (a) 
(1). However, the establishment is not required 
to submit a report card or surveillance form pur- 
suant to Paragraphs (a) (2) and (a) (3). 

(c) For the purposes of reporting by restaurants 
and other food or drink establishments pursuant 
to G.S. 130A-138, the diseases and conditions to 
be reported shall be those listed in 15A NCAC 
19A .0101 (5), (7), (10), (14), (18), (45), (46), 
(50), (53) and (54). 

(d) Laboratories required to report test results 
pursuant to G.S. 130A-139 shall report as fol- 
lows: 

(1) The specified tests for syphilis and 
gonorrhea shall be reported to the local 
health department by the first and fif- 
teenth of each month. Reports of 
gonorrhea and syphilis shall be made on 
a form provided by the Department and 
shall include the specimen collection date, 
the patient's age, race, and sex, and the 
submitting physician's name, address, and 
telephone numbers. 

(2) Positive darkfield examinations for syphilis 
shall be reported within 24 hours to the 
II IV SID Control Branch by telephone. 

(3) Positive tuberculosis test results shall be 
reported to the Tuberculosis Control 
Branch on a form provided bv the De- 
partment within seven days. 



Statutory Authority G.S. 130A-I34; I30A-J35; 
1 30 A- 141. 

.0103 DUTIES LOCAL HEALTH DIRECTOR: 
REPORT COMMUNICABLE DISEASES 

(a) L'pon receipt of a report of a communicable 
disease or condition pursuant to 15A NCAC 19A 
.0101, the local health director shall: 

(1) immediately investigate the circumstances 
surrounding the occurrence of the disease 
or condition to determine the authenticity 
of the report and the identity of all per- 
sons for whom control measures are re- 
quired. This investigation shall include 
the collection and submission for labora- 
tory examination of specimens necessary 
to assist in the diagnosis and indicate the 
duration of control measures; 

determine what control measures have 

been given and ensure that proper control 

measures as provided in 15A NCAC 19A 

.0201 have been given and are being 

complied with; 

forward the report as follows: 

(A) The local health director shall forward 

all authenticated reports made pursuant 

to G.S. B OA- 135 to 137 of syphilis. 

chlamydial infection, 

granuloma inguinale, and 

venereum 

syphilis a« 



(2) 



(3) 



chancroid, 
gonorrhea, 
lymphogranuloma 
nongonococcal urethritis. a«4 



specified m 44A NCAC 44£ -MOh 



within seven days to the regional office of 
the HIV SID Control Branch. In addi- 
tion, the local health director shall tele- 
phone reports of aH cases of primary, 
secondary', and earlv latent (under one 
year's duration) syphilis to the regional 
office of the HIV SID Control Branch 
within 24 hours of diagnosis at the health 
department or report bv a physician. 
(B) The local health director shall telephone 
all laboratory reports of reactive syphilis 
serologies to the regional office of the 
HIV STD Control Branch within 24 
hours of receipt if the person tested is 
pregnant . This shall also be done for all 
other persons tested unless the dilution is 
less than 1:8 and the person is known to 
be over 25 years of age or has been previ- 
ously treated. In addition, the written re- 
ports shall be sent to the regional office 



of the HIV.- STD Control 
seven dav: 



Branch within 



(C) (-&} Except as provided m (a)(3)(A) and 
(B), a local health director who receives a 
report pursuant to 15A NCAC 19A .0102 



6:7 NORTH CAROLINA REGISTER July 1, 1 99 1 



342 



PROPOSED RULES 



regarding a person residing in that juris- 
diction shall forward the authenticated re- 
port to the Division of Epidemiology 
within seven days. 
(D) (€-^ Except as provided in (a)(3)(A) and 
j B 1 . a local health director who receives a 
report pursuant to 15A NCAC 19A .0102 
regarding a person who resides in another 
jurisdiction in North Carolina shall for- 
ward the report to the local health director 
of that jurisdiction within 24 hours. A 
duplicate report card marked ''copy'' shall 
be forwarded to the Division of 
Epidemiology within seven days. 
(E i (-&•} A local health director who receives 
a report pursuant to 15A NCAC 19A 
.0102 regarding a person who resided 
outside of North Carolina at the time of 
onset of the illness shall forward the report 
to the Division of Epidemiology" within 
24 hours. 
( b ) Whenever a cluster of cases of a reportable 
disease or condition occurs, the local health di- 
rector shall investigate the cluster to determine if 
an outbreak exists. If an outbreak exists, the lo- 
cal health director shall submit to the Division 
of Epidemiology within 30 days a written report 
of the investigation, its findings, and the actions 
taken to control the outbreak and prevent a re- 
currence. 

(ci Whenever a cluster of cases of a disease or 
condition occurs which is not required to be re- 
ported by 15A NCAC 19A .0101 but which re- 
presents a significant threat to the public health, 
the local health director shall investigate the 
cluster to determine if an outbreak exists. If an 
outbreak exists, the local health director shall 
give appropriate control measures consistent with 
15A NCAC 19A .0200. and inform the Division 
of Epidemiology of the circumstances of the 
outbreak within seven days. 

Statutory Authority G.S. I30A-141; BOA-144. 

SECTION .0200 - CONTROL MEASURES FOR 
COMMUNICABLE DISEASES 

.0201 CONTROL MEASURES - GENERAL 

(a) Except as provided in Rules .0202 aft4 .0203 
.0205 of this Section, the specific control moas 
««*? recommendations and guidelines for testing, 
diagnosis, treatment, follow-up, and prevention 
of transmission for each disease and condition 
shall 1*^ those* specified by the American Public 
Health Association in its publication, Control of 
Communicable Disease in Man shall be the re- 
quired control measures Control of 
Communicable Disease in Man is hereby 



adopted by reference in accordance with G.S. 
150B- 14(c). Copies of this publication are 
available from the American Public Health As- 
sociation, Department JE, 1015 15th Street, 
N.W., Washington, DC 20005. A copy is avail- 
able for inspection in the Communicable Disease 
Control Section, Cooper Memorial Health 
Building. 225 N. McDowell Street, Raleigh, 
North Carolina 27602. 

(b) In interpreting and implementing the spe- 
cific control measures adopted in Paragraph (a) 
of this Rule, and in devising control measures for 
outbreaks designated by the State Health Direc- 
tor and for communicable diseases and condi- 
tions for which a specific control measure is not 
provided by this Rule, the following principles 
shall be used: 

( 1 ) control measures shall be those which can 
reasonably be expected to decrease the 
risk of transmission and which are con- 
sistent with recent scientific and public 
health information: 

(2) for diseases or conditions transmitted by 
the airborne route, the control measures 
shall require physical isolation for the du- 
ration of infectivity: 

(3) for diseases or conditions transmitted by 
the fecal-oral route, the control measures 
shall require exclusions from situations in 
which transmission can be reasonably ex- 
pected to occur, such as work as a paid 
or voluntary food handler or attendance 
or work in a day care center for the dura- 
tion of infectivity; 

(4) for diseases or conditions transmitted by 
sexual or the blood-bome route, control 
measures shall require prohibition of do- 
nation of blood, tissue, organs, or semen, 
needle-sharing, and sexual contact m a 
manner likely to result in transmission for 
the duration of infectivity. 

(c) Persons with congenital rubella syndrome, 
tuberculosis, and carriers of Salmonella typhi and 
hepatitis B who change residence to a different 
local health department jurisdiction shall notify 
the local health director in both jurisdictions. 

(d) Isolation and quarantine orders for 
communicable diseases and communicable con- 
ditions for which control measures have been es- 
tablished shall require compliance with 
applicable control measures and shall state pen- 
alties for failure to comply. These isolation and 
quarantine orders may be no more restrictive 
than the applicable control measures. 

(e) Health care workers, including emergency 
responders and funeral service personnel, shall 
follow blood and body fluid precautions with all 
patients. 



343 



6:7 XORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



(f) All equipment used to puncture human skin 
(in medical or other settings) must be disposed 
of in accordance with 15A NCAC 13B after use 
or sterilized prior to reuse. 

(g) An individual enrolled in an epidemiologic 
or clinical study shall not be required to meet the 
provisions of ISA NCAC 19A .0201 : .0205 
which conflict with the study protocol if 

( 1) the protocol is approved for this purpose 
by the State Health Director because of 
the scientific and public health value of 
the study, and 

(2) the individual fully participates in and 
completes the study. 

Statutory Authority G.S. 130A-135; I30A-144. 

.0202 CONTROL MEASURES - HIV 

The following are the control measures for the 
Acquired Immune Deficiency Syndrome (AIDS) 
and Human Immunodeficiency Virus (HIV) in- 
fection: 

(1) Infected persons shall: 

(a) refrain from sexual intercourse unless 
condoms are used; exercise caution when 
using condoms due to possible condom 
failure; 

(b) not share needles or syringes; 

(c) not donate or sell blood, plasma, platelets, 
other blood products, semen, ova, tissues, 
organs, or breast milk; 

(d) have a skin test for tuberculosis; 

(e) notify future sexual intercourse partners 
of the infection; if the time of initial in- 
fection is known, notify persons who have 
been sexual intercourse and needle part- 
ners since the date of infection; and, if the 
date of initial infection is unknown, notify 
persons who have been sexual intercourse 
and needle partners for the previous year. 

(2) The attending physician shall: 

(a) give the control measures in Paragraph (1) 
of this Rule to infected patients, in ac- 
cordance with 15A NCAC 19A .0210; 

(b) give the patient a form provided by the 
Division of Epidemiology and encourage 
its use for listing partners for whom no- 
tification is required in Subparagraph 
(l)(e) of this Rule; the physician shall en- 
courage the patient to arrange an ap- 
pointment with a Division of 
Epidemiology AIDS counselor regarding 
partner notification and to complete the 
form, and either take it to the Division of 
Epidemiology AIDS counselor or mail it 
to the Division so that the Division may 
undertake counseling of the partners to 
prevent further transmission. The Divi- 



sion of Epidemiology shall destroy the fist 
after it has counseled the partners or after 
a reasonable attempt has been made to do 
so; 

(c) If the attending physician knows the iden- 
tity of the spouse of an HIV-infected pa- 
tient and has not, with the consent of the 
infected patient, notified and counseled 
the spouse appropriately, the physician 
shall list the spouse on a form provided 
by the Division of Epidemiology and shall 
mail the form to the Division; the Divi- 
sion will undertake to counsel the spouse; 
the attending physician's responsibility to 
notify exposed and potentially exposed 
persons is satisfied by fulfilling the re- 
quirements of Subparagraph (2)(b) and 
(c) of this Rule; 

(d) advise infected persons concerning proper 
clean-up of blood and other body fluids; 

(e) advise infected persons concerning the risk 
of perinatal transmission and transmission 
by breastfeeding. 

(3) The attending physician of a child who is 
infected with HIV and who may pose a sig- 
nificant risk of transmission in the school or 
day care setting because of open, oozing 
wounds or because of behavioral abnor- 
malities such as biting shall notify the local 
health director. The local health director 
shall consult with the attending physician 
and investigate the circumstances. 

(a) If the child is in school or scheduled for 
admission and the local health director 
determines that there may be a significant 
risk of transmission, the local health di- 
rector shall consult with an interdiscipli- 
nary committee, which shall include 
appropriate school personnel, a medical 
expert, and the child's parent or guardian 
to assist in the investigation and determi- 
nation of risk. The local health director 
shall notify the superintendent or private 
school director of the need to appoint 
such an interdisciplinary committee. 

(i) If the superintendent or private school 
director establishes such a committee 
within three days of notification, the local 
health director shall consult with this 
committee. 

(ii) If the superintendent or private school 
director does not establish such a com- 
mittee within three days of notification, 
the local health director shall establish 
such a committee. 

(b) If the child is in school or scheduled for 
admission and the local health director 
determines, after consultation with the 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



344 



PROPOSED RULES 



committee, that a significant risk of trans- 
mission exists, the local health director 
shall: 
(i) notify the parents; 
(ii) notify the committee; 
(hi) assist the committee in determining 
whether an adjustment can be made to the 
student's school program to eliminate sig- 
nificant risks of transmission; 
(iv) determine if an alternative educational 
setting is necessary to protect the public 
health; 
(v) instruct the superintendent or private 
school director concerning appropnate 
protective measures to be implemented in 
the alternative educational setting devel- 
oped by appropriate school personnel; 
and 
(vi) consult with the superintendent or pri- 
vate school director to determine which 
school personnel directly involved with 
the child need to be notified of the HIV 
infection in order to prevent transmission 
and ensure that these persons are in- 
structed regarding the necessity for pro- 
tecting confidentiality. 
(c) If the child is in day care and the local 
health director determines that there is a 
significant risk of transmission, the local 
health director shall notify the parents that 
the child must be placed in an alternate 
child care setting that eliminates the sig- 
nificant risk of transmission. 
(4) When health care workers or other persons 
have had- a nonsexual blood w body fluid 
exposure a needlestick or nonsexual non- 
intact skin or mucous membrane exposure 
to blood or hodv fluids that poses a signif- 
icant risk of 1 1IV transmission, the following 
shall apply: 
(a) When the source person is known: 

(i) The attending physician or occupational 
health care provider responsible for the 
exposed person, if other than the attend- 
ing physician of the shall notify the at- 
tending physician af- the person whose 
blood or body fluids is the source of the 
exposure, shall notify the attending physi- 
cian of the source that an exposure has 
occurred. U the attending physician (4 the 
source person knows t4+e- sources HIV 
mtection status. the physician shall trans 
fffo tfo* information te- the attending 
pin -. ician fo the expo soil person, if the 
The attending physician of the source 
person does not- know the infection status 
fo" the source person, the physician shall 
discuss the exposure with the source and 



if the source person is at hfoh risk- fof HIV 
inf e ction shall request permission fof tost 
fog test the source for HIV infection if 
permission is grunted, the source shall be 
tested, if permission is d e nied, the local 
health dir e ctor i*h*¥ order t e sting &f the 
source if the local health director deter 
mines that the e xposure poses a significant 
risk- el transmission ef II IV affo that- the 
source i§ at- high risk fof HIV infection. 
unless the source is already known to be 
infected. Whether ef not- the source is 
tested, the The attending physician of the 
exposed person shall be notified of the risk 
status ef the source a&4 the infection sta- 
tus of the source, if known. 
(ii) The attending physician of the exposed 
person shall inform the exposed person 
about the infection status of the source, if 
known, offer testing for HIV infection as 
soon as possible after exposure and at 
reasonable intervals up to one year to de- 
termine whether transmission occurred, 
and, if the physician determines that- th e re 
i* a substantial ri-4* that the source person 
was HIV infected, give the exposed person 
the control measures listed in (l)(a) 
through (c) of this Rule. The attending 
physician of the exposed person shall in- 
struct the exposed person regarding the 
necessity for protecting confidentiality. 

(b) When the source person is unknown, the 
attending physician of the exposed person 
shall inform the exposed person of the risk 
of transmission and offer testing for HIV 
infection as soon as possible after expo- 
sure and at reasonable intervals up to one 
year to determine whether transmission 
occurred. 

(c) A health care facility may release the name 
of the attending physician of a source 
person upon request of the attending 
physician of an exposed person. 

(5) The attending physician shall notify the 
local health director when the physician, in 
good faith, has reasonable cause to suspect 
a patient infected with HIV is not following 
or cannot follow control measures and is 
thereby causing a significant nsk of trans- 
mission. 

(6) When the local health director is notified 
pursuant to Paragraph (5) of this Rule, of a 
person who is mentally ill or mentally re- 
tarded, the local health director shall confer 
with the attending mental health physician 
or appropriate mental health authority and 
the physician who notified the local health 



345 



6:7 NORTH CAROLINA REGISTER July /, 1991 



PROPOSED RULES 



director to develop an appropriate plan to 
prevent transmission. 

(7) The Director of Health Services of the 
North Carolina Department of Correction 
and the prison facility administrator shall be 
notified by the attending physician ef a«y 
HIV infoctod poroon confined *«• a stat e 
prison when any person confined in a state 
prison is determined to be infected with 
HIV. If the prison facility administrator, in 
consultation with the Director of Health 
Services, determines that a confined 
HIV-infected person is not following or 
cannot follow prescribed control measures, 
thereby presenting a significant risk of HIV 
transmission, the administrator and the Di- 
rector shall develop and implement jointly a 
plan to prevent transmission, including 
making appropriate recommendations to the 
unit housing classification committee. 

(8) The local health director shall ensure that 
the health plan for local jails include educa- 
tion of jail staff and prisoners about HIV, 
how it is transmitted, and how to avoid ac- 
quiring or transmitting this infection. 

(9) Health care workers with HIV infection 
who have secondary infections or open skin 
lesions which would place patients at risk 
shall not provide direct patient care. Oth- 
erwise, these control measures do not re- 
quire restrictions in the workplace of persons 
with HIV infection. 

(10) Local health departments shall provide 
free testing for HIV infection with individual 
pre- and post-test counseling. By August 
1, 1991, the State Health Director shall des- 
ignate a minimum of 16 local health depart- 
ments to provide anonymous testing. 
Beginning September 1, 1991, only cases of 
confirmed HIV infection identified by 
anonymous tests conducted at local health 
departments designated as anonymous test- 
ing sites pursuant to this Subparagraph shall 
be reported in accordance with 15A NCAC 
19A .0102(a)(3). /Ml other cases of con- 
firmed HIV infection shall be reported in 
accordance with 15A NCAC 19A 
.0102(a)(1) and (2). Effective September 1, 
1994, anonymous testing shall be discontin- 
ued and all cases of confirmed HIV infection 
shall be reported in accordance with 15A 
NCAC 19A .0102(a)(1) and (2). 

(11) Appropriate counseling for HIV testing 
shall include individualized pre- and post- 
test counseling which provides risk assess- 
ment, risk reduction guidelines, appropriate 
referrals for medical and psychosocial ser- 
vices, and, when the person tested is deter- 



mined to be infected with HIV, control 
measures. 

(12) A person charged with an offense that in- 
volves nonconsensual vaginal, anal, or oral 
intercourse, or that involves vaginal, anal, 
or oral intercourse with a child 12 years old 
or less shall be tested for HIV infection if: 

(a) probable cause has been found or an 
indictment has been issued; 

(b) the victim notifies the local health director 
and requests information concerning the 
HIV status of the defendant; and 

(c) the local health director determines that 
the alleged sexual contact involved in the 
offense would pose a significant risk of 
transmission of HIV if the defendant were 
HIV infected. If in custody of the De- 
partment of Correction, the person shall 
be tested by the Department of Cor- 
rections and if not in custody, the person 
shall be tested by the local health depart- 
ment. The Department of Corrections 
shall inform the local health director of all 
such test results. The local-health director 
shall inform the victim of the results of the 
test, counsel the victim appropriately, and 
instruct the victim regarding the necessity 
for protecting confidentiality. 

(13) A local health department or the Depart- 
ment may release information regarding an 
infected person pursuant to G.S. 
130A- 143(3) only when the local health de- 
partment or the Department has provided 
direct medical care to the infected person 
and refers the person to or consults with the 
health care provider to whom the informa- 
tion is released. 

(14) Notwithstanding the provisions of 15A 
NCAC 19A .0202, when a person with HIV 
infection is enrolled in a study of the efficacy 
of alternative methods of notifying past sex- 
ual and needle partners, such notification 
shall be made in accordance with the study 
protocol if: 

(a) the study protocol is approved by the 
State Health Director; and 

(b) the person with HIV infection fully par- 
ticipates in and completes the study. 

(15) Notwithstanding Rule .0201(d) of this 
Section, a local or state health director may 
include in an isolation order for 
HIV-infected persons a requirement that the 
infected person attend education and coun- 
seling sessions about how HIV is transmit- 
ted and how to prevent transmission, 
participate in appropnate mental health or 
substance abuse counseling and treatment. 
or participate in vocational rehabilitation if 



6:7 NORTH CAROLINA REGISTER July I, 1991 



346 



PROPOSED RULES 



the HIV-infected person otherwise qualifies 
for these services. 

Statutory Authority G.S. BOA- 135; 1 30 A- 144. 

.0204 CONTROL MEASURES - SEXUALLY 
TRANSMITTED DISEASES 

(a) Local health departments shall provide di- 
agnosis, testing, treatment, follow-up, and pre- 
ventive services for syphilis, gonorrhea, 
chlamydia, nongonococcal urethritis, 
mucopurulent cervicitis, chancroid, 
lymphogranuloma venereum, and granuloma 
inguinale. These services shall be provided upon 
request and at no charge to the patient. 

(b) Persons infected with, exposed to, or rea- 
sonably suspected of being infected with syphilis, 
lymphogranuloma venereum, granuloma 
inguinale, and chancroid shall: 

(1) Refrain from sexual intercourse until ex- 
amined, diagnosed and treatment is com- 
pleted, and all lesions are healed: 

(2) Be tested, treated, and re-evaluated in ac- 
cordance with the STD Treatment 
Guidelines published by the U.S. Public 
Health Service, which are adopted by ref- 
erence in accordance with G. S. 
150B- 14(c). However, urethral Gram 
stains may be used for diagnosis of males 
rather than gonorrhea cultures unless 
treatment has failed; 

(3) Notify all sexual partners from 30 days 
before the onset of symptoms to com- 
pletion of therapy that they must be eval- 
uated by a physician or local health 
department. 

(c) Persons infected with, exposed to, or rea- 
sonably suspected of being infected with syphilis, 
lymphogranuloma venereum. granuloma 
inguinale, and chancroid shall: 

(1) Refrain from sexual intercourse until ex- 
amined, diagnosed, and treatment is com- 
pleted, and all lesions are healed; 

(2) Be tested, treated, and re-evaluated in ac- 
cordance with the STD Treatment 
Guidelines published by the U.S. Public 
Health Service, except that chancroid cul- 
tures shall not be required; 

(3) Give names to a disease intervention spe- 
cialist employed by the local health de- 
partment or by the HIV, STD Control 
Branch for contact tracing of all sexual 
partners and others as listed in (c). (3), 
(A), (i). (ii), (in), (iv), (B), (i), (u), (C), 
and (D) of this Rule: 

(A) for syphilis: 

(i) congenital - all immediate family 
members: 



(ii) primary - all partners from three 
months before the onset of symptoms 
to completion of therapy and healing 
of lesions; 

(iii) secondary - all partners from six 
months before the onset of symptoms 
to completion of therapy and healing 
of lesions; and 

(iv) latent - all partners from 12 months 
before the onset of symptoms to com- 
pletion of therapy and healing of lesions 
and, in addition, for women with late 
latent, spouses and children; 

(B) for lymphogranuloma venereum: 

(i) if there is a primary lesion and no 
buboes, all partners from 30 days before 
the onset of symptoms to completion 
of therapy and healing of lesions; and 

(ii) if there are buboes all partners from 
six months before the onset of symp- 
toms to completion of therapy and 
healing of lesions; 

(C) for granuloma inguinale - all partners 
from three months before the onset of 
symptoms to completion of therapy and 
healing of lesions; and 

(D) for chancroid - all partners from ten 
days before the onset of symptoms to 
completion of therapy and healing of 
lesions. 

(d) All persons evaluated or reasonably sus- 
pected of being infected with any sexually trans- 
mitted disease shall be tested for syphilis, 
encouraged to be tested confidentially for HIV, 
and counseled about how to reduce the risk of 
acquiring sexually transmitted disease, including 
the use of condoms. 

(e) All pregnant women shall be tested for 
syphilis and gonorrhea early in pregnancy and in 
the third trimester. Pregnant women at high risk 
for exposure to syphilis and gonorrhea shall also 
be tested for syphilis and gonorrhea at the time 
of delivery. 

(f) AH newborn infants shall be treated 
prophylactically against gonococcal ophthalmia 
neonatorum in accordance with the STD Treat- 
ment Guidelines published by the U. S. Public 
Health Service. 

Statutory Authority G. S. BOA- 135; BOA -144. 

.0205 CONTROL MEASURES - 
TUBERCULOSIS 

(a) The local health director shall promptly 
investigate all cases of tuberculosis disease and 
their contacts in accordance with the provisions 
of Control of Communicable Diseases in Man. 



34' 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



(b) The following persons shall be skin tested 
for tuberculosis and given appropriate clinical, 
microbiologic and x-ray examination in accord- 
ance with the "Diagnostic Standards and Classi- 
fication of Tuberculosis," published by the 
Amercian Thoracic Society, which is adopted by 
reference in accordance with G. S. 150B- 14(c): 

(1) Household and other close contacts of 
active cases of tuberculosis; 

(2) Persons reasonably suspected of having 
tuberculosis disease; 

(3) Inmates in the custody of, and staff with 
direct inmate contact in, the Department 
of Corrections upon incarceration or em- 
ployment, and annually thereafter; 

(4) Patients and staff in long term care facili- 
ties upon admission or employment and 
annually thereafter; 

(5) Clients and staff in residential facilities 
operated by the Department of Human 
Resources upon admission or employ- 
ment and annually thereafter. 

(c) Treatment and follow-up for tuberculosis 
infection or disease shall be in accordance with 
"Treatment of Tuberculosis and Tuberculosis 
Infection in Adults and Children," published by 
the Amercian Thoracic Society, which is adopted 
by reference in accordance with G. S. 150B- 14(c). 
However, liver function testing shall not be re- 
quired for persons under 35 years of age with no 
symptoms of liver disease. Infected persons shall 
complete treatment and treatment shall not be 
interrupted for more than two months unless: 

(1) They are asymptomatic, have a normal 
chest x-ray, are 35 years of age or older, 
and are not at high risk of developing 
tuberculosis as provided in "Treatment of 
Tuberculosis and Tuberculosis Infection 
in Adults and Children," published by the 
American Thoracic Society; or 

(2) A medical panel consisting of at least two 
physicians employed by Tuberculosis 
Control Branch and the Chief or Assistant 
Chief for Science of the Communicable 
Disease Control Section approve discon- 
tinuation of therapy. 

(d) The attending physician shall instruct all 
patients treated for tuberculosis regarding the 
potential side effects of the medications pre- 
scribed and to promptly notify the physician if 
side effects occur. 

(e) Persons with pulmonary or laryngeal 
tuberculosis who are known or reasonably sus- 
pected to be infected with .Mycobacterium 
tuberculosis resistant to the usual medications 
used for treatment shall be restricted to their 
homes, an appropriate health care facility, or in 



some other appropriate manner to prevent 
transmission until: 

(1) they are free of cough; or 

(2) three consecutive smears or cultures are 
negative; or 

(3) they have been compliant for at least three 
weeks on medications to which the 
organism is known to be susceptible and 
have responded clinically. 

(f) Persons with pulmonary or laryngeal 
tuberculosis who are hospitalized, in prison, or a 
longterm care facility, shall be placed in respir- 
atory isolation until: 

(1) they are free of cough; or 

(2) three consecutive smears or cultures are 
negative; or 

(3) been compliant for at least three weeks on 
medications to which the organism is rea- 
sonably thought to be susceptible and 
have responded clinically. 

(g) Persons with known or suspected 
pulmonary tuberculosis who work in a health 
care or institutional setting or who work in or 
attend child daycare or with known or suspected 
laryngeal tuberculosis shall be restricted to their 
homes, an appropriate health care facility, or in 
some other appropriate manner to prevent 
transmission until: 

(1) they are free of cough; or 

(2) three consecutive smears or cultures are 
negative; or 

(3) they have been compliant for at least three 
weeks on medications to which the 
organism is reasonably thought to be sus- 
ceptible and have responded clinically. 

Statutory Authority G. S. I30A-I35; 130,1-144. 

.0213 COMMUNICABLE DISEASE FINANCIAL 
GRANTS AND CONTRACTS 

(a) The Communicable Disease Control Sec- 
tion may enter into financial arrangements with 
local health departments, community hospitals, 
nursing homes, or other convalescent facilities, 
and with physicians for the purpose of providing 
specific health care services for communicable 
diseases and the implementation of the control 
measures prescribed in this Rule. 

(b) The HIV/STD Control Branch may au- 
thorize a local health department to obtain re- 
quired diagnostic and treatment services for 
persons with syphilis, gonorrhea, chancroid, 
lymphogranuloma venereum, and granuloma 
inguinale from phsicians: 

(1) The amount to be charged for these ser- 
vices shall be negotiated between the local 
health department and the physician and 
approved by the HIV/STD Control 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



34S 



PROPOSED RULES 



Branch at the lowest agreeable rate, not 
to exceed approved Medicaid reimburse- 
ment rates. Drugs used in treatment may 
be provided to such physicians by the lo- 
cal health department. 
(2) The physician shall bill the local health 
department for services provided. The 
local health department shall submit re- 
quests for payment to the HIV,STD 
Control Branch on forms provided by the 
Division of Epidemiology. 
(c) The Tuberculosis Control Branch may: 

( 1 ) Contract with hospitals to provide inpa- 
tient diagnostic and hospitalization ser- 
vices for eligible tuberculosis patients if: 

(A) Private rooms with negative air pressure 
with respect to the hallways and other 
rooms are available; 

(B) A qualified physician is willing to ac- 
cept inpatient referrals from surrounding 
counties; 

(C) There is a laboratory that performs 
mycobacterial studies at the hospital; 

(D) There is a radiological department at 
the hospital, including a radiologist; 

(E) There is an infection control program 
at the hospital to monitor the staff and 
patients to minimize the occurrence of 
nosocomial tuberculosis infection; 

(F) There is a program at the hospital to 
ensure that the risk for employees devel- 
oping or transmitting tuberculosis is low; 
and 

(G) Funds are available. 

(2) Contract with licensed nursing homes or 
other convalescent facilities to provide in- 
patient treatment and convalescent care to 
eligible tuberculosis patients if: 

(A) Private rooms with negative air pressure 
with respect to the hallways and other 
rooms are available; 

(B) A qualified physician is willing to ac- 
cept inpatient referrals; 

(C) There is an infection control program 
to monitor the staff and patients to mini- 
mize the occurrence of nosocomial 
tuberculosis infection; 

(D) There is a program to ensure that the 
risk for employees developing or trans- 
mitting tuberculosis is low; 

(1) Necessary laboratory tests, radiological 
and transportation services are available 
at the facility, through contracts, or by 
some other arrangement; and 

(F) Funds are available. 



Statutory Authority G. 
1 30 A- 144. 



S. 130 A- 5; I30A-135; 



.0214 ELIGIBILITY FOR TUBERCULOSIS 
HOSPITALIZATION SERVICES 

(a) A patient shall be medically eligible for 
payment for up to seven days inpatient 
hospitalization for diagnosis of tuberculosis at a 
hospital designated by the Tuberculosis Control 
Branch pursuant to Rule .0213 of this Section 
and the patient is suspected of having 
Mycobacterium tuberculosis disease based upon 
the finding of one or more of the following: 

(1) Evidence of acid-fast bacilli found by di- 
rect microscopy or by culture techniques; 

(2) Histopathologic evidence of tuberculosis 
in an active form; 

(3) Positive tuberculin skin test reaction using 
intermediate strength purified protein de- 
rivative fPPD), five tuberculin units and 
suggestive sysptoms; 

(4) X-ray or clinical evidence suggestive of the 
presence of tuberculosis in an active form; 
or 

(5) Epidemiologic information supportive of 
a diagnosis of tuberculosis in an active 
form. 

(b) If a patient is diagnosed as having 
Mycobacterium tuberculosis by a physician li- 
censed to practice medicine in this State, then the 
patient shall be medically eligible for up to 21 
days of hospitalization per year beginning the 
first day of financial eligibility for the treatment 
of the disease and for the cost of ambulance ser- 
vices from the contracting hospital to a 
program-designated medical facility. 

(c) If the head of the Tuberculosis Control 
Branch determines that additional treatment is 
medically necessary because of the tuberculosis 
condition, the head of the Branch may extend the 
period of medical eligibility beyond the periods 
specified in Paragraph (a) and (b) of this Rule. 

(d) The medical care payments described in this 
Rule are available only for services provided at a 
hospital which has contracted with the 
Tuberculosis Program for these services. 

(e) Financial eligibility and payment proce- 
dures shall be determined in accordance with re- 
quirements for medical care payments found in 
15A NCAC 24A. 

Statutory Authority G. S. I30A-5; 130A-135; 
130 A- 144. 

.0215 ELIGIBILITY FOR TUBERCULOSIS 
NURSING HOME SERVICES 

(a) A patient shall be medically eligible for re- 
imbursement for up to 60 days per year for 
treatment and convalescent services at a nursing 
home designated bv the Tuberculosis Control 



349 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



Branch pursuant to Rule .0213 of this Section 
and the following criteria are met: 

(1) The applicant has active pulmonary or 
disseminated tuberculosis associated with 
incapacitation or significant debilitation 
which requires a SNF or 1CF level of care. 
To aid in making this determination, the 
referring physician shall provide a treat- 
ment plan and project a length of stay for 
the patient at the nursing home. 

(2) The applicant has positive bacteriology for 
tuberculosis. The positive bacteriology 
(AFB) must have been obtained within 
the preceding 14 days. 

(3) The applicant does not need an acute level 
of hospital care for any condition. 

(4) The applicant is 16 years of age or over. 

(5) The applicant is referred by a licensed 
physician who has first-hand knowledge 
of the applicant's mental and physical 
condition. The referring physician shall 
furnish a summary of the applicant's 
physical and mental condition and known 
infirmities, and specific details of treat- 
ment and medication the applicant is tak- 
ing with orders for dosage, frequency and 
duration. This summary shall include all 
known allergies and previous reactions to 
anti-tuberculosis and all other 
medications. In addition, dietary needs, 
pertinent x-rays, and copies of laboratory 
reports shall be forwarded with the patient 
or in advance. 

(6) The head of the Tuberculosis Control 
Branch may make exceptions to the crite- 
ria contained in Subparagraphs (1) 
through (5) of this Paragraph if the patient 
would be best treated for tuberculosis at 
a licensed nursing home. 

(b) If the head of the Tuberculosis Control 
Branch determines that additional treatment or 
convalescent care at a licensed nursing home is 
medically necessary because of tuberculosis, the 
head of the Branch may extend medical eligibility 
for more than 60 days per year. 

(c) Financial eligibility and payment proce- 
dures shall be determined in accordance with 1 5A 
NCAC 24A. 

Statutory Authority G. S. 1 30 A- 5; 130A-I35; 
BOA- 144. 

SECTION .0400 - IMMUNIZATION 

.0401 DOSAGE AND AGE REQUIREMENTS 
FOR IMMUNIZATION 

(a) Every individual in North Carolina required 
to be immunized pursuant to G.S. 130A-152 



through 130A-157 shall be immunized against 
the following diseases by receiving the specified 
minimum doses of vaccines by the specified ages: 

(1) diphtheria, tetanus, and whooping cough 
— five doses: three doses by age one year 
and two booster doses, one in the second 
year of fife and the second on or after the 
fourth birthday and before enrolling in 
school (K-l) for the first time; 

(2) oral poliomyelitis vaccine--three doses of 
trivalent type by age two years and a 
booster dose of trivalent type on or after 
the fourth birthday and before enrolling 
in school (K-l) for the first time; two 
doses of enhanced-potency inactivated 
poliomyelitis vaccine may be substituted 
for two does of oral poliomyelitis vaccine. 

(3) measles (rubeola) vaccine -- one dose of 
live, attenuated vaccine by age two years; 

(4) rubella vaccine -- one dose of five, atten- 
uated vaccine by age two years; 

(5) mumps vaccine— one dose of five atten- 
uated vaccine by age two years; 

(6) Hemophilus influenzae. Ix conjugate vac- 
cine 2i three doses of HbOC or two doses 
of PRP-OMP bv age one year and a 
booster dose of any type by the second 
birthday. 

(b) Notwithstanding the requirements of Para- 
graph (a) of this Regulation: 

(1) An individual who has attained his or her 
seventh birthday without having been 
immunized against whooping cough shall 
not be required to be immunized with a 
vaccine preparation containing whooping 
cough antigen. 

(2) An individual who has been documented 
by serologic testing to have a protective 
antibody titer against rubella shall not be 
required to receive rubella vaccine. 

(3) An individual who has been diagnosed by 
a physician licensed to practice medicine 
as having measles (rubeola) disease shall 
not be required to receive measles vaccine. 

(4) An individual attending school who has 
attained his or her 18th birthday shall not 
be required to receive oral polio vaccine. 

(5) An individual born prior to 1957 shall not 
be required to receive measles vaccine. 
An individual who has attained his or her 
fiftieth birthday shall not be required to 
receive rubella vaccine. An individual 
who entered a college or university after 
his or her thirtieth birthday and before 
February 1, 1989 shall not be required to 
meet the requirement for rubella vaccine. 

(6) E xcept as provided in Subparagraph (h)(S) 

of this Rule, the requirements for mumps 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



350 



PROPOSED RULES 



vaccine, and for booster doses of 
diphtheria, tetanus, and whooping cough 
vaccine and oral poliomyelitis vaccine, 
shall not apply to individuals who en- 
rolled for the first time in the first grade 
before July 1, 1987. 

(7) Individuals who receive the first booster 
dose of diphtheria, tetanus, and whooping 
cough vaccine on or after the fourth 
birthday shall not be required to have a 
second booster dose. Individuals who re- 
ceive the third dose of oral poliomyelitis 
vaccine on or after the fourth birthday 
shall not be required to receive a fourth 
dose. 

(8) Individuals attending a college or univer- 
sity shall be required to have three doses 
of diphtheria tetanus toxoid of which one 
must have been within the last ten years. 

(9) Individuals born before October L 1991 
shall not be required to be vaccinated 
against Hemophilus influenzae, b. 



Statutory 
1 30 A- 155. 1. 



A uthority 



G.S. 



BOA- 152(c), 



SUBCHAPTER I9D - TUBERCULOSIS 
CONTROL 

SECTION .0100 - GENERAL POLICIES 

.0101 SCOPE (REPEALED) 

.0102 FINANCIAL GRANTS IN AID 

(REPEALED) 
.0103 REPORTING OF TUBERCULOSIS 

CASES (REPEALED) 
.0104 EXAMINATION RESULTS (REPEALED) 
.0105 SOURCE OF CONTROL GUIDELINES 

AND MEASURES (REPEALED) 

Statutory Authority G.S. I30A-I77. 

SECTION .0200 - REPORTING OF 
TUBERCULOSIS CASES 

.0201 REPORTING GENERALLY (REPEALED) 
.0202 TUBERCULOSIS SUSPECTS/HEALTH 

DEPARTMENTS (REPEALED) 
.0203 VERIFICATION OF CASE 

REPORTS (REPEALED) 

Statutory Authority G.S. 130A-I77. 

.0204 LABORATORY REPORTS (REPEALED) 

Statutory Authority G.S. I3QA-I39; 130A-I41. 

SECTION .0300 - MOVEMENT OF 

TUBERCUUOSIS CASES, CONTACTS, AND 

SUSPECTS 



.0301 DEFINITION OF EPIDEMIOLOGIC 

INFORMATION (REPEALED) 
.0302 MOVEMENT WITHIN STATE 

(REPEALED) 
.0303 MOVEMENT OUTSIDE STATE 

(REPEALED) 
.0304 CONFIDENTIALITY (REPEALED) 

Statutory Authority G.S. 130A-177. 

SECTION .0400 - SERVICES AND GRANTS 

.0401 CLINICIAN SERVICES (REPEALED) 
.0402 NURSING SERYICES (REPEALED) 
.0403 X-RAY TECHNOLOGY CONSULTANT 

SERVICES (REPEALED) 
.0404 ANTI-TUBERCULOSIS DRUGS 

(REPEALED) 
.0405 FINANCIAL GRANTS AND 

CONTRACTS (REPEALED) 
.0406 PAYMENTS FOR MEDICAL 

CARE (REPEALED) 
.0407 MEDICAL ELIGIBILITY (REPEALED) 

Statutory Authority G.S. 130A-I77. 

SUBCHAPTER 19F - SEXUALLY 
TRANSMITTED DISEASE CONTROL 

SECTION .0100 - GENERAL POLICIES 

.0101 SCOPE (REPEALED) 

Statutory Authority G.S. BOA- 160. 

.0103 TECHNICAL ASSISTANCE (REPEALED) 

.0104 DRUGS (REPEALED) 

.0105 REIMBURSEMENT FOR EXAMINATION 

AND TREATMENT SERVICES (REPEALED) 

Statutory Authority G.S. BOA- 160. 

SECTION .0200 -SYPHILIS CONTROL 
PROGRAM 

.0201 SCOPE (REPEALED) 

Statutory Authority G.S. BOA-160. 
.0203 CASE INTERVIEW (REPEALED) 

Statutory Authority G.S. BOA-160. 

SECTION .0300 - GONORRHEA CONTROL 
PROGRAM 

.0301 SCOPE (REPEALED) 

.0302 SCREENING (REPEALED) 

.0303 CONTRACTS FOR LABORATORY 

SERVICES (REPEALED) 
.0304 PATIENT INTERVIEW AND 

COUNSELING SESSIONS (REPEALED) 
.0305 PREVENTION OF OPHTHALMIA 



351 



6: 



\ORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



NEONATORUM (REPEALED) 

Statutory Authority G.S. 1 30 A- 1 60. 

SECTION .0400 - REPORTING 

.0401 CASE REPORTS (REPEALED) 
.0402 PRIVATE LABORATORY 
REPORT (REPEALED) 

Statutory Authority G.S. I30A-139; 130A-141; 
BOA- 160. 

CHAPTER 20 - LABORATORY SERVICES 

SUBCHAPTER 20C - MILK AND WATER 
LABORATORY CERTIFICATION 

.0002 WATER LABORATORY CERTIFICATION 

Water laboratories in local health departments, 
commercial laboratories, and industrial laborato- 
ries are certified by this laboratory to perform 
bacteriological, chemical, and radio-chemical ex- 
aminations for determining the sanitary quality 
of water in accordance with United Statoo Public 
Health Drinlring Wat or Standards United States 
Environmental Protection Agency (FPA) Safe 
Drinking Water Act and 15A NCAC 18C. 

Statutory Authority G.S. 130A-S8. 

SUBCHAPTER 20D - CERTIFICATION AND 
IMPROVEMENT 

SECTION .0200 - LABORATORY 
CERTIFICATION 

.0201 SCOPE (REPEALED) 

.0202 NOTICE AND PROCEDURE 

(REPEALED) 
.0203 CERTIFICATION: CERTIFICATION 

RENEWAL: AND FEES (REPEALED) 

Statutory Authority G.S. 130A-3I5; 130A-326. 

.0204 REVOCATION, DOWNGRADING OR 

DENIAL (REPEALED) 
.0205 RECERTIFICATION (REPEALED) 
.0206 CERTIFICATION OF OUT-OF-STATE 

LABORATORIES (REPEALED) 
.0207 CONTRACT LABORATORIES 

(REPEALED) 

Statutory Authority G.S. 130A-315; 130A-326. 

.0208 CHEMISTRY FACILITIES 

(REPEALED) 
.0209 CHEMISTRY EQUIPMENT (REPEALED) 
.0210 CHEMISTRY GENERAL LABORATORY 

PRACTICES (REPEALED) 
.0211 CHEMISTRY METHODOLOGY 

(REPEALED) 



.0212 CHEMISTRY SAVIPLES (REPEALED) 
.0213 CHEMISTRY QUALITY CONTROL 

(REPEALED) 
.0214 CHEMISTRY DATA (REPEALED) 
.0215 CHEMISTRY ACTION RESPONSE 

(REPEALED) 
.0216 MICROBIOLOGY FACILITIES 

(REPEALED) 
.0217 MICROBIOLOGY EQUIPMENT 

(REPEALED) 
.0218 MICROBIOLOGY GENERAL 

LABORATORY PRACTICES (REPEALED) 
.0219 MICROBIOLOGY METHODOLOGY 

(REPEALED) 
.0220 MICROBIOLOGY SAMPLES 

(REPEALED) 
.0221 MICROBIOLOGY QUALITY CONTROL 

(REPEALED) 
.0222 MICROBIOLOGY DATA (REPEALED) 
.0223 MICROBIOLOGY ACTION RESPONSE 

(REPEALED) 
.0224 RADIOCHEMISTRY FACILITIES 

(REPEALED) 

Statutory Authority G.S. I30A-3I5. 

.0226 RADIOCHEMISTRY GENERAL 

LABORATORY PRACTICES (REPEALED) 
.0227 RADIOCHEMISTRY METHODS AND 

SAMPLING (REPEALED) 
.0228 RADIOCHEMISTRY QUALITY 

CONTROL (REPEALED) 
.0229 RADIOCHEMISTRY DATA (REPEALED) 
.0230 RADIOCHEMISTRY ACTION 

RESPONSE (REPEALED) 

Statutory Authority G.S. 130A-315. 

.0231 SCOPE 

A laboratory wishing to perform analyses of 
public water systems pursuant to 15A NCAC 
18C .1500 shall be certified by the Division of 
Laboratory Services and shall meet the minimum 
requirements for certification contained in Rules 
.0231 through .0261 of this Section for each test 
category it wishes to perform. A laboratory may 
also be certified by the Division if certified by the 
United States Environmental Protection Agency 
(EPA). 

Statutory Authority G.S. I30A-3I5. 

.0232 NOTICE AND PROCEDURE 

(a) A laboratory seeking certification shall re- 
quest in writing an application for certification 
from the Division of Laboratory Services. The 
application for certification shall include: 

(1) Name and address of the laboratory and 
its ovvner(s) or directors; 

(2) Names and qualifications of the laboratory 
personnel; 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



352 



PROPOSED RULES 



(3) Test categories for which certification is 
requested; 

(4) Description of facilities, equipment, and 
methodologies; 

(5) Such other information as the Department 
of Environment, Health, and Natural Re- 
sources deems necessary for certification 
purposes. 

(b) l.'pon review of the application by a state 
laboratory certification evaluator, and successful 
analyses of water performance samples, an on- 
site visit shall be scheduled to evaluate the labo- 
ratory premises. 

(c) A written report describing deviations from 
minimum requirements shall be prepared by the 
laboratory certification evaluator and submitted 
to the laboratory director or other responsible 
person. Within 30 days of receiving the written 
report, the laboratory shall submit a letter with 
supporting documents (records, reports, data, 
purchase orders, or other documents) showing 
the action taken to comply with the minimum 
requirements. The letter shall be sent to the 
laboratory certification evaluator for review. 

Statutory Authority G.S. BOAS IS. 

.0233 CERTIFICATION, CERTIFICATION 
RENEWAL AND FEES 

(a) The Department of Environment, Health, 
and Natural Resources shall grant certification 
for the test categories requested upon finding that 
a laboratory meets the minimum requirements 
set forth in this Section. 

(b) A laboratory may renew its certification 
every year by payment of the certification fee by 
December 1 of the preceding year. If the fee has 
not been paid by December 31 of each year, the 
laboratory's certification shall not be renewed for 
the next year, and the laboratory shall apply for 
recertification pursuant to Rule .0235 of this 
Section. In addition to payment of the certif- 
ication fee, an on-site evaluation by a laboratory 
certification evaluator and compliance with the 
minimum requirements of this Section are re- 
quired for renewal. 

(c) The certificate and information pertaining 
to certification shall remain the property of the 
Department of Environment, Health, and Na- 
tural Resources and shall be surrendered upon 
decertification pursuant to Rule .0234 of this 
Section. All certification information shall be 
available for public access pursuant to Chapter 
132 of North Carolina General Statutes. 

(d) The certification fee shall be twenty dollars 
($20.00) per analyte. The minimum and maxi- 
mum fee per analyte group shall be as set out in 



G.S. 130A-326(7). The analyte groups are as 
follows: 

(1) inorganic chemistry; 

(2) organic chemistry I (synthetic organic 
chemicals); 

(3) organic chemistry II (volatile organic 
chemicals); 

(4) total coliforms; and 

(5) radio chemistry. 

The certification fee shall not be prorated nor 
refunded. Twenty percent shall be due at the 
time of the application. 

Statutory Authority G.S. 130A-315; 130A-326. 

.0234 CRITERIA/F'ROCEDLRES FOR 

DECERTIFICATION, DENIAL, OR 
DOWNGRADING 

(a) The Department of Environment, Health, 
and Natural Resources or its delegate may 
downgrade or deny laboratory' certification if the 
laboratory: 

(1) Demonstrates incompetence or made 
consistent errors in analyses; 

(2) failed to correctly analyze performance 
evaluation samples, including L'nited 
States Environmental Protection Agency 
water study, double blind, blind, and on- 
site samples, or failed to report the results 
within the specified time; 

(3) failed to report analytical results of per- 
formance evaluation samples or compli- 
ance samples or maintain records as 
required by this Section and the Rules 
Governing Public Water Supplies in 15A 
NCAC 18C .1500; 

(4) Failed to maintain facilities and equipment 
in accordance with the minimum require- 
ments of this Section; 

(5) Failed to notify the certification evaluator 
of major changes such as personnel, 
equipment, or laboratory location; or 

(6) Violated or aided and abetted in the vio- 
lation of any provisions of the rules of this 
Section. 

(b) A downgraded laboratory with provisional 
certification may continue to perform analyses. 
The provisional status shall continue for at least 
six months. At the end of six months the labo- 
ratory certification shall be reinstated if the labo- 
ratory has made corrections and is in compliance 
with the minimum requirements for certification. 
If no corrections have been made the laboratory 
certification may be revoked. 

(c) The Department of Environment, Health, 
and Natural Resources or its delegate may de- 
certify or denv laboratory certification when a 



353 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



laboratory or its employees have done any of the 
following: 

(1) Knowingly made false statements on any 
documents associated with certification; 

(2) Falsified results of analyses; 

(3) Submitted performance evaluation sam- 
ples used for certification determination to 
another laboratory for analysis; 

(4) Failed to employ approved laboratory 
methodology in the performance of the 
analyses required by 15A NCAC 18C 
.1500; 

(5) Repeatedly failed to correctly analyze per- 
formance evaluation samples including 
United States EPA water study, double 
blind, blind, and on-site samples or report 
the results within the specified time; 

(6) Repeatedly failed to report analytical re- 
sults of performance evaluation samples 
or compliance samples or maintain re- 
cords as required by this Section and the 
Rules Governing Public Water Supplies 
in 15A NCAC 18C; 

(7) Failed to satisfy the certification evaluator 
that the laboratory has corrected devi- 
ations identified during the on-site visit 
within 30 days; or 

(8) Violated or aided and abetted in the vio- 
lation of any provisions of the rules of this 
Section. 

(d) The Department of Environment, Health, 
and Natural Resources or its delegate shall notify 
a laboratory of its intent to decertify, downgrade 
to provisional status or deny certification. The 
notice shall be in writing and include reasons for 
the decision and shall be delivered by certified 
mail. 

(e) This Rule shall not preclude informal con- 
ferences concerning a decision to decertify, 
downgrade to provisional status or deny certif- 
ication. 

Statutory Authority G.S. 130A-315. 

.0235 RECERTIFI CATION 

(a) A laboratory is eligible for recertification six 
months after decertification, except in the fol- 
lowing instances: 

(1) A laboratory which lost certification for 
false statements on documents, falsified 
analytical results, or submitted official 
performance samples to another labora- 
tory, is eligible for recertification one year 
after decertification. Application for re- 
certification shall be made in the same 
way as application for certification as 
contained in Rule .0233 of this Section; 



(2) A laboratory which lost certification for 
failure to correctly analyze performance 
evaluation samples is eligible for recertif- 
ication after satisfying Rule .0243(b)(4) or 
.0251(4), or both of this Section, 
(b) A laboratory for which certification was not 
renewed for failure to pay the certification fee by 
the date required in Rule .0233 of this Section is 
eligible for recertification 60 days after paying the 
overdue fee. 

Statutory Authority G.S. 130A-315; 130A-326. 

.0236 CERTIFICATION OF OUT-OF-STATE 
LABS 

(a) An out-of-state laboratory shall meet all the 
following conditions to obtain North Carolina 
certification to perform analyses for compliance 
with 15A NCAC 18C .1500: 

(1) The laboratory shall be certified under a 
similar program administered by the state 
in which the facility is located or must be 
certified by the United States Environ- 
mental Protection Agency (EPA); 

(2) The laboratory shall provide this office 
with its EPA performance evaluation data 
within 30 days of the receipt of those data; 

(3) An initial on-site inspection shall be con- 
ducted by one or more laboratory certif- 
ication evaluators at the requesting 
laboratory's expense. The Department 
shall not be required to conduct follow-up 
inspections more than once per year. 
Follow-up inspections shall be conducted 
at the requesting laboratory's expense; 

(4) The laboratory shall pay fees as prescribed 
in Rule .0233 of this Section; and 

(5) The laboratory shall notify the North 
Carolina Department of Environment, 
Health, and Natural Resources within 30 
days of any changes in its certification 
status pursuant to the actions of another 
agency. 

(b) The laboratory's failure to comply with any 
or all of the conditions in Paragraph (a) of this 
Rule will prevent the laboratory from obtaining 
certification in North Carolina or result in 
downgrading or decertification in North 
Carolina. 

Statutory Authority G.S. 130A-315. 

.0237 CONTRACT LABORATORIES 

(a) A laboratory may sub-contract analytical 
work to another laboratory if the sub-contracting 
laboratory has been certified by the Department 
of Environment, Health, and Natural Resources 
as required in Rule .0231 of this Section. 



6:7 NORTH CAROLINA REGISTER July 1, 1 99 1 



354 



PROPOSED RULES 



(b) Any data generated through a sub-contract 
shall be reported on the report form of the labo- 
ratory that performed the sub-contracted ana- 
lyses and shall be signed by the responsible 
person. 

Statutory Authority G.S. J30A-3/5. 

.0238 CHEMISTRY FACILITIES 

The laboratory facilities shall be clean, be tem- 
perature and humidity controlled in the instru- 
ment areas to allow proper operation and have 
sufficient lighting at the bench top to perform the 
required procedures. 

Statutory Authority G.S. 130A-315. 

.0239 CHEMISTRY EQUIPMENT AND 
INSTRUMENTATION 

The laboratory is required to have those instru- 
ments that are needed to perform the approved 
methods for which certification has been re- 
quested. 

Statutory Authority G.S. I30A-3I5. 

.0240 CHEMISTRY LABORATORY PRACTICES 

The following chemistry laboratory practices 
shall apply: 

( 1 ) General: 

(a) Chemicals and reagents. Analytical rea- 
gent grade (AR) chemicals or better grade 
shall be used for analyses. Individual an- 
alytical methods in the approved refer- 
ences may specify additional requirements 
for the reagents to be used. 

(b) Laboratory safety. Where safety practices 
are included in an approved method, they 
shall be strictly followed. 

(2) Inorganic Contaminants: 

(a) Reagent water. The laboratory shall have 
a source of reagent water having a 
resistivity value of at least 0.5 megohms 
(less than 2.0 micromhos) at 25°C. 
Quality checks to meet these specifica- 
tions shall be made at planned intervals 
of at least once per month. 

(b) Glassware preparation. Glassware shall 
be washed in a warm detergent solution 
and thoroughly rinsed first with tap water 
and then with reagent water. This clean- 
ing procedure is sufficient for general ana- 
lytical needs, but the individual 
procedures shall be referred to for prec- 
autions to be taken against contamination 
of glassware. 

(3) Organic Contaminants: 



(a) Reagent water. Reagent water for organic 
analysis shall be free of interferences for 
the analytes being measured. Water shall 
be treated when necessary to eliminate 
interferences. 

(b) Glassware preparation. Glassware and 
sample bottles shall be washed in a deter- 
gent solution and thoroughly rinsed first 
in tap water and then in reagent water. 
Glassware shall have a final organic sol- 
vent rinse or shall be baked at 400°C for 
30 minutes and then dried or cooled in an 
area free of organic contamination. 
Glassware shall be covered with organic- 
free aluminum foil during storage. Bottles 
and cap liners, used for collection of sam- 
ples for determination of volatile organic 
chemicals (VOCs) shall be dried at 105°C 
for one hour, sealed, and stored in an area 
free of volatile organics. 

Statutory Authority G.S. 130A-3I5. 

.0241 CHEMISTRY METHODOLOGY 

Minimum equipment requirements and meth- 
odology for individual parameters of chemical 
analvses shall be in accordance with methods 
adopted in 15A NCAC 18C .1515, 15A NCAC 
18C .1522, and 15A NCAC 18C .1513. A list 
of these methods may be obtained from the Di- 
vision of laboratory Services. 

Statutory Authority G.S. I30A-3I5. 

.0242 CHEMISTRY SAMPLE COLLECTION, 
HANDLING AND PRESERN ATION 

(a) A written sampling protocol with specific 
sampling instructions shall be available to sample 
collectors and available for inspection by the 
certification officer. 

(b) The following handling and preservation 
requirements of samples shall apply: 

(1) Rejection of samples. The laboratory 
shall reject any samples taken for compli- 
ance purposes that do not meet the crite- 
ria in Subparagraphs (b)(2) - (b)(5) of this 
Rule, and shall notify the system or indi- 
vidual requesting the analyses. 

(2) Sample containers and preservation. The 
type of sample container and the required 
preservative for each inorganic and or- 
ganic chemical contaminant shall meet the 
criteria of Tables IV-4 and IV- 5 in the 
EPA "Manual for the Certification of 
laboratories Analyzing Drinking Water", 
which is herebv adopted by reference 
pursuant to G.S.' 150B- 14(c). 



355 



6:7 NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



(3) Maximum holding times. Samples shall 
be analyzed within the maximum holding 
times listed in Tables IV-4 and IV-5 in the 
EPA "Manual for the Certification of 
Laboratories Analyzing Drinking Water", 
which is hereby adopted by reference 
pursuant to G.S. 150B- 14(c). 

(4) Sample collection and transport. The 
laboratory shall accept only those samples 
which have been collected, identified and 
transferred to the laboratory in accordance 
with the rules of this Section and 15A 
NCAC 18C .1500. 

(5) Sample report form. The sample report 
form shall contain the location; date; and 
time of collection; collector's name; 
preservative added; and any other special 
remarks concerning the sample. Sample 
report forms shall be approved by the 
North Carolina Public Water Supply 
Section. Indelible ink shall be used to 
complete the form. 



Statutory Authority G.S. J30A-3/5. 

.0243 CHEMISTRY QUALITY ASSURANCE 

(a) The following general requirements for 
chemistry quality assurance (QA) shall be met: 

(1) All quality control information shall be 
available for inspection by the certification 
officer; 

(2) A manual of analytical methods and the 
laboratory's QA plan shall be available to 
the analysts; 

(3) Class S weights or higher quality weights 
shall be available to make periodic checks 
on the accuracy of the balances. Checks 
shall be within range of the manufactur- 
er's guidelines. A record of these checks 
shall be available for inspection. The 
specific checks and their frequency are to 
be as prescribed in the laboratory's QA 
plan or the laboratory's operations man- 
ual. These checks shall be performed at 
least once a month; 

(4) Color standards or their equivalent, such 
as built-in internal standards, shall be 
available to verify wavelength settings on 
spectrophotometers. These checks shall 
be within the manufacturer's tolerance 
limits. A record of the checks shall be 
available for inspection. The specific 
checks and their frequency shall be as 
prescribed in the laboratory's QA plan or 
the laboratory's operations manual. 
These checks shall be performed at least 
every six months. 



(b) The laboratory shall analyze performance 
samples as follows: 

(1) United States Environmental Protection 
Agency performance evaluation samples 
shall be analyzed semi-annually. Results 
shall be within control limits established 
by EPA for each analyte for which the 
laboratory is or wishes to be certified. 

(2) Double blind samples shall be analyzed 
when submitted to a certified laboratory 
and results shall be within established 
control limits; these data shall be of equal 
weight to the EPA performance evalu- 
ation sample data and on-site quality 
control sample data in determining the 
laboratory's certification status. 

(3) On-site quality control samples shall be 
analyzed when presented to the laboratory 
by the certification evaluator and results 
shall be within established control limits. 
These data shall be of equal weight to the 
EPA performance evaluation sample data 
and the double blind sample data in de- 
termining the laboratory's certification 
status. 

(4) A performance level of 75 percent shall 
be maintained for each analyte for which 
a laboratory is or wishes to be certified. 
This 75 percent average shall be calculated 
from the ten most recent performance 
sample data points from the EPA water 
studies, double-blind, Mind, and on-site 
samples. 

(5) Unacceptable performance on any of the 
samples in Paragraph (b) of this Rule 
shall be corrected and explained in writing 
within 30 days and submitted to the cer- 
tification evaluator. 

(c) The minimum daily quality control (QC) 
for chemistry shall be as follows: 

(1) Inorganic Contaminants: 

(A) At the beginning of each day that 
samples are to be analyzed, a standard 
curve composed of at least a reagent blank 
and three standards covering the sample 
concentration range shall be prepared. 

(B) The laboratory shall analyze a QC 
sample (EPA QC sample or equivalent) 
at the beginning of the sample run, at the 
end of the sample run, and every 20 sam- 
ples, with recoveries not to exceed _+_ 10 
percent of the true concentration. The 
source of this QC sample shall be different 
from the source used for the calibration 
standards in Paragraph (c)(1)(A) of this 
Rule. 

(C) The laboratory shall run an additional 
standard or QC check at the laboratory's 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



356 



PROPOSED RULES 



lowest detectable limit for the particular 
analyte. The laboratory shall not report 
a value lower than the lowest standard or 
QC check analyzed. 

(D) The laboratory shall add a known spike 
to a minimum of 10 percent of the routine 
samples (except when the method speci- 
fies a different percentage, i.e. furnace 
methods) to determine if the entire ana- 
lytical system is in control. The spike 
concentration shall not be substantially 
less than the background concentration 
of the sample selected for spiking. The 
spike recoveries shall not exceed _+_ 10 
percent of the true value. 

(E) All compliance samples analyzed by 
graphite furnace shall be spiked to deter- 
mine absence of matrix interferences with 
recoveries _+_ 10 percent of the true value 
of the spike concentration. 

(F) The laboratory shall run a duplicate 
sample every 10 samples with duplicate 
values within _j_ 10 percent of each other. 

(G) Precision and accuracy data may be 
computed from the analyses of check 
samples of known value used routinely in 
each analytical procedure. This data shall 
be available for inspection by the labora- 
tory evaluator. 

(2) Organic Contaminants: 

(A) Quality control specified in the ap- 
proved methods referenced in Rule .0241 
shall be followed. 

(B) Analysis for regulated volatile organic 
chemicals under 15A NCAC 18C .1515 
shall only be conducted by laboratories 
that have received conditional approval 
bv EPA or the Department according to 
40 C.F.R. I41.24(g)(10) and (11) which 
is hereby adopted bv reference pursuant 
to G.S. 150B-14(c). ' 

(C) Analysis for unregulated volatile or- 
ganic chemicals under 15A NCAC 18C 
.1516 shall only be conducted by labora- 
tories approved under Subparagraph 
(c)(2)(B) of this Rule. In addition to the 
requirements of Subparagraph (c)(2)(B) 
of this Rule, each laboratory analyzing for 
EDB and DBCP shall achieve a method 
detection limit for FDB and DBCP of 
0.00002 mg 1, according to the procedures 
in Appendix B of 40 C.F.R. Part 136 
which is hereby adopted by reference 
pursuant to G.S. 1 SOB- 14(c). 

Statutory Authority G.S. 130A-3I5. 

.0244 CHEMISTRY DATA 



Records of chemical analyses shall be kept by 
the laboratory in accordance with the EPA 
"Manual for Certification of Laboratories Ana- 
lyzing Drinking Water", Chapter 4, Section 8, 
Records and Data Reporting, which is hereby 
adopted by reference pursuant to G.S. 
150B-14(c). 

Statutory Authority G.S. I30A-3JS. 

.0245 CHEMISTRY ACTION RESPONSE 

All laboratory results exceeding maximum con- 
taminant levels shall be reported to the Public 
Water Supply Section of the Division of Envi- 
ronmental Health within 48 hours. All other 
laboratory results shall be reported in accordance 
with the Public Water Supply rules in 15A 
NCAC 18C. 

Statutory Authority G.S. 130A-315. 

.0246 MICROBIOLOGY FACILITIES 

Laboratory facilities shall be clean, temperature 
and humidity controlled, and have sufficient 
lighting at bench tops to perform the required 
procedures. The laboratory shall have provisions 
for disposal of microbiological waste. 

Statutory Authority G.S. 130A-315. 

.0247 MICROBIOLOGY EQUIPMENT, 
SUPPLIES AND ASSOCIATED 
QUALITY CONTROL 

(a) A laboratory seeking certification for 
microbiological analyses of water shall have 
available, or have access to. the items required for 
the total coliform and fecal coliform procedures 
as listed in the EPA "Manual for the Certif- 
ication of Laboratories Analyzing Drinking Wa- 
ter", Chapter 5. Section 3, Laboratory 
[Equipment and Supplies which is hereby adopted 
by reference pursuant to G.S. 150B- 14(c), except 
that Sections 3.2.2, 3.5.4 and 3.11.5 are not 
adopted by reference. 

(b) In addition to the items and procedures 
adopted by reference in Paragraph (a) of this 
Rule the laboratory shall have available the items 
and follow the procedures listed in this Para- 
graph: 

(1) Balance. Calibrate the balance monthly 
using class S or S-l reference weights. 

(2) Autoclave. The autoclave shall be 
checked at least weekly with a maximum 
registering thermometer. Heat sensitive 
tape or spore strips or ampules may be 
used during each autoclave cycle and re- 
sults recorded. 

(3) Fecal Coliform Waterbath: 



357 



6:7 NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



(A) A temperature of 44.5°C +_ 0.2°C shall 
be maintained. 

(B) A thermometer graduated in 0.1°C in- 
crements shall be used to monitor tem- 
perature. 

(C) The water level shall be sufficient to 
reach the upper level of media in tubes. 

(D) On days used, record temperature at 
least twice per day with readings separated 
by at least four hours. 

Statutory Authority G.S. I30A-3I5. 

.0248 MICROBIOLOGY GENERAL 
LABORATORY PRACTICES 

(a) The general laboratory practices for micro- 
biological analyses shall be in accordance with 
those listed in the EPA "Manual for the Certif- 
ication of Laboratories Analyzing Drinking Wa- 
ter", Chapter 5, Section 4, General Laboratory 
Practices, which is hereby adopted by reference 
pursuant to G.S. 150B- 14(c), except that 
Sections 4.6.1 through 4.9 are not adopted by 
reference. 

(b) In addition, the following laboratory prac- 
tices shall be followed: 

(1) Media - General Requirements. Check 
each lot of medium with positive and 
negative culture controls. 

(2) Membrane Filter Media: 

(A) Use m-Endo broth or agar or LES 
Endo broth or agar in the single step or 
enrichment techniques. Ensure that 
ethanol used in rehydration procedure is 
not denatured. Prepare medium in a 
sterile flask and use a boiling water bath 
or, if constantly attended, a hot plate with 
a stir bar to bring medium to the boiling 
point. Do not boil medium. Final pH 
shall be 7.2 +_ 0.2. 

(B) Refrigerate MF broth no longer than 
96 hours, poured MF agar plates no 
longer than two weeks, and ampoulcd 
m-Endo broth in accordance with man- 
ufacturer's expiration date. 

(3) Multiple Tube Fermentation (MTF) Me- 
dia: 

(A) Use double strength lauryl sulfate broth 
or lactose broth in the presumptive test 
and single strength brilliant green lactose 
bile (BGLB) broth in the confirmed test. 
Autoclave media at 12LC for 12 minutes. 
Final pH shall be 6.8 +_ 0.2 or 7.2 _+_ 0.2 
for BGLB broth. 

(B) If MTF media are refrigerated after 
sterilization, incubate overnight at 35°C 
+ 0.5 D C before use. Discard tubes 
showing growth or bubbles. Use MTF 



media prepared in tubes with loose fitting 
closures within one week. Store broth 
media in screw cap tubes or bottles no 
longer than three months, provided media 
are stored in the dark. Discard media if 
evaporation exceeds 10 percent of original 
volume. 
(C) LES Endo agar shall be used for the 
completed test. Refrigerate autoclaved 
medium and use within two weeks. 

(4) Clark's Total Coliform Medium: 

(A) Autoclave for 12 minutes at 121°C. 
Allow space between bottles. 

(B) Final pH shall be 6.8 +_ 0.2. 

(C) Store prepared medium in screw capped 
culture bottle no longer than .three 
months; discard if evaporation exceeds 10 
percent of original volume. 

(5) EC Medium (for fecal coliforms): 

(A) Autoclave for 12 minutes at 121°C. 

(B) Examine tubes after sterilization to in- 
sure that inverted inner tubes are free of 
air bubbles and that the vials are at least 
partially covered with medium. 

(C) Incubate refrigerated sterilized medium 
overnight at 35°C +_ 0.5°C; discard tubes 
that show growth or bubbles. 

(D) Store prepared medium in screw cap 
tubes. 

"(E) Final pH shall be 6.9 +_ -0.2. 

(6) EC + MUG Medium (for detection of 
fecal coliforms-£. coli): 

(A) Autoclave medium at 12LC (gas tubes 
shall not be used). 

(B) Final pH shall be 6.9 +_ 0.2. 

(C) Store prepared medium in screw cap 
tubes no longer than three months. 

(7) MMO-MUG Test Medium (for Total 
Coliform and E. Coli): 

(A) The laboratory shall not prepare this 
medium from basic ingredients. 

(B) Each lot purchased shall be tested for 
performance by inoculation with three 
control bacteria: Escherichia coli, a total 
coliform other than E. coli (e.g., Klebsiella 
pneumoniae) and a non-coliform (e.g., 
Pseudomonas aeruginosa). These control 
organisms can be stock cultures or com- 
mercially available discs impregnated with 
the organism. Incubate these controls at 
35°C +_ 0.5°C for 24 hours, and read and 
record result. 

(C) Do not autoclave. 

(8) Fecal Coliform Membrane Filter Medium 
(for enumeration of fecal coliform in 
source water): 

(A) Rehydrate medium in reagent water 
containing 10 ml of 1 percent rosolic acid 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



35S 



PROPOSED RULES 



in 2N NaOH. Bring it to the boiling 
point; do not autoclave. 

(B) Autoclave for 12 minutes at 12PC. 

(C) Final pH shall be 7.4 +_ 0.2. 

(D) Refrigerate unused prepared medium; 
discard after 96 hours. 

(9) Heterotrophic Plate Count (HPC) Me- 
dium: 

(A) Autoclave HPC agar at 121°C for 15 
minutes. 

(B) Final pH shall be 7.0 +_ 0.2. 

(C) Temper melted agar at 44°-46 : C before 
pouring. 

(D) Hold melted agar no longer than four 
hours. Do not melt sterile agar medium 
more than once. 

Statutory Authority G.S. /30A-3/5. 

.0249 MICROBIOLOGY METHODOLOGY 

(a) Minimum equipment requirements and 
methodology for microbiological analyses shall 
be in accordance with the methods adopted in 
40 CFR 141.21(f) which is hereby adopted by 
reference pursuant to G.S. 1 SOB- 14(c), except 
that Nutrient Agar plus MUG in 40 CFR 
141.21(f)(6)(H) is not adopted by reference. 

(b) For total coliform analysis the laboratory 
shall maintain certification for one or more of the 
approved methods as specified in this Paragraph: 

(1) The Membrane Filter Procedure (MF) 
may be used for drinking water when the 
sample is free from interference (e.g., 
turbidity and particulates). A laboratory 
must be approved for a second analytical 
procedure when MF is used. 

(2) The Multiple Tube Fermentation (MTF) 
procedure may be used for analyzing 
drinking water that contains particulates 
or other interfering substances and may 
be used as the back up or the sole ap- 
proved method. 

(3) The MMO-MUG (Colilert) procedure 
may be used for analyzing drinking water 
that contains particulates. A laboratory 
must be approved for a second analytical 
procedure when MMO-MUG is used. 

(c) A laboratory shall maintain certification for 
one of the approved methods for fecal coliform 
analysis. 

(d) For all procedures in Paragraph (a) of this 
Rule incubate inoculated culture within 30 min- 
utes of inoculation. 

Statutory Authority G.S. I30A-3I5. 

.0250 MICROBIOLOGY SAMPLE, 
COLLECTION, HAMMING 



AND PRESERVATION 

(a) For sample collecting, handling, and pres- 
ervation, there shall be strict adherence to correct 
sampling procedures, complete identification of 
the sample, and prompt transfer of the sample to 
the laboratory as described in "Standard Meth- 
ods for the Examination of Water and 
Wastewater", American Water Works Associ- 
ation, Part 9060, which is adopted by reference 
in accordance with G.S. 150B- 14(c). 

(b) Minimum sample frequency and sample 
location shall be that specified in 15A NCAC 
18C .1534. 

(c) The collector shall be trained in sampling 
procedures or written instructions shall be pro- 
vided by the laboratory. 

(d) The water shall be sampled after maintain- 
ing a steady flow for two or three minutes to clear 
service line. The tap shall be free of aerator, 
strainer, hose attachment, or water purification 
devices. 

(e) The sample volume shall be a minimum of 
100 ml. The sample bottle must be filled only 
to the shoulder to provide space for mixing. 

(f) The sample report form shall be completed 
immediately after collection with location, date 
and time of collection, chlonne residual, collec- 
tor's name, and remarks. The report form shall 
be approved by the North Carolina Public Water 
Supply Section. 

(g) Date and time of sample arrival shall be 
added to the sample report form when the sam- 
ple is received in the laboratory. 

(h) Samples shall be received and analyzed 
within 48 hours of time of collection. Samples 
that are not analyzed within 48 hours must be 
rejected and a new sample must be collected. 

Statutory Authority G.S. 130A-315. 

.0251 MICROBIOLOGY QUALITY 
ASSLRANCE 

Requirements for quality assurance are as fol- 
lows: 

(1) A written quality assurance (QA) plan shall 
be available for review. 

(2) Records on analytical quality control tests 
on media and equipment shall be prepared 
and retained for three years. 

(3) A performance level of 75 percent shall be 
maintained for each method for which a 
laboratory is. or wishes to be certified. This 
75 percent average shall be calculated from 
the 10 most recent performance sample data 
points from water performance studies, 
double blind, blind and on-site samples. 

(4) For other quality control requirements refer 
to Rules .0247 and .0248 of this Section. 



359 



6:7 NORTH CAROLINA REGISTER July I, 1991 



PROPOSED RULES 



Statutory Authority G.S. BOAS 1 5. 

.0252 MICROBIOLOGY DATA 

(a) Where the laboratory has the responsibility 
for microbiological sample collections, the sam- 
ple collector shall complete a sample report form 
immediately after each sample is taken. The in- 
formation on the form includes sample identifi- 
cation number, sample collector's name, time 
and date of collection, arrival time and date in the 
laboratory and other information as required. 

(b) Results of microbiological analyses shall 
be calculated and entered on the sample report 
form to be forwarded to Public Water Supply 
Section of the Division of Environmental Health. 
A careful check shall be made to verify that each 
result was entered correctly from the bench sheet 
and initialed by the analyst. 

(c) A copy of the microbiological sample report 
form shall be retained by the laboratory for three 
years. If results are entered into a computer 
storage system, a printout of the data shall be 
returned to the laboratory for verification with 
bench sheets. 

Statutory Authority G.S. J30A-3J5. 

.0253 MICROBIOLOGY ACTION RESPONSE 

All laboratory results exceeding maximum con- 
taminant levels shall be reported to the Public 
Water Supply Section of the Division of Envi- 
ronmental Health within 48 hours. All other 
laboratory results shall be reported in accordance 
with the Public Water Supply rules in 15A 
NCAC ISC. 

Statutory Authority G.S. I30A-3I5. 

.0254 RADIOCHEMISTRY FACILITIES 

A laboratory seeking certification for perform- 
ance of radiochemical analyses of public water 
supplies shall meet the following requirements: 

(1) The counting instrument(s) required for 
measurement of those radionuclides de- 
scribed in 15A NCAC 18C .1500 shall be 
located in a separate room from rooms in 
which samples and standards are being pre- 
pared or other types of chemical analyses are 
being performed. The temperature of this 
room shall not exceed 27°C. Temperature 
variation under normal operating conditions 
shall not exceed 3°C. 

(2) All instruments shall be properly grounded, 
and a regulated power supply, either external 
or internal, shall be available to each instru- 
ment. 



(3) In areas where radioactive standards are 
being prepared, care shall be taken to mini- 
mize contamination of surfaces and person- 
nel. Bench surfaces shall be an impervious 
material covered with absorbent paper, or 
trays (stainless steel, plastic, or fiberglass) 
lined with absorbent paper. 

(4) Laboratory space shall be 200 square feet 
per person and shall contain no less than 6 
linear feet of bench space per analyst and 
include the following: 

(a) sink with hot and cold running water; 

(b) electrical outlets (120 V a.c. grounded); 

(c) source of distilled or deionized water; 

(d) gas supply (natural gas or liquefied petro- 
leum); a propane cylinder with proper at- 
tachments may be permitted in 
laboratories doing limited amounts of an- 
alytical work; 

(e) vacuum line, pump, or aspirator; and 

(f) exhaust hood. 

Statutory Authority G.S. 130A-3I5. 

.0255 RADIOCHEMISTRY EQUIPMENT 

(a) The only instruments required shall be 
those needed to perform the specific 
radiochemical analyses for which the laboratory 
is being certified. Those instruments shall meet 
the specifications as listed in the EPA "Manual 
for the Certification of Laboratories Analyzing 
Drinking Water", Chapter 6, Section 3, Labora- 
tory Equipment and Supplies, which is hereby 
adopted by reference pursuant to G.S. 
150B- 14(c). 

(b) In addition, the laboratory shall have the 
following instruments if they are required for the 
radiochemical analyses: 

(1) Conductivity meter. Readable in ohms 
or mhos, with a range of 2 to 2.5 million 
ohms or equivalent mhos _+_ 1 percent, 
and a sensitivity of 0.33 percent or better. 
Meter may be either line/bench or 
batten/portable. 

(2) Fluorometer. Capable of detecting 0.0005 
ug of uranium. 

Statutory Authority G.S. /30A-3/5. 

.0256 RADIOCHEMISTRY GENERAL 
LABORATORY PRACTICES 

A laboratory seeking certification for performing 

radiochemical analyses shall meet the following 

requirements: 

(1) Glassware preparations. All glassware shall 

be washed in a warm detergent solution and 

thoroughly rinsed in tap water. A distilled 

water rinse shall follow the tap water rinse. 



6:7 NORTH CAROLINA REGISTER July I, 1991 



360 



PROPOSED RULES 



Further cleaning is not required unless spe- 
cific analytical methods dictate the need for 
more elaborate procedures for ensuring 
cleanliness of glassware, those procedures 
shall be followed. 

(2) Water quality. All water used in prepara- 
tion of reagents, standards, and samples shall 
have resistance values greater than 0.5 
megohms (less than 2.0 micromhos) cm at 
25 : C. 

(3) Chemicals and reagents. Analytical reagent 
grade (AR ) chemicals shall be used for most 
analyses. 

(4) Storage of radioactive standards and radio- 
active wastes. There shall be an enclosed 
and properly labeled area, either within the 
analytical laboratory or in a separate room, 
for the safe storage (in suitable containers) 
of standards, samples, and radioactive 
wastes. 

(5) Standards and sample preparation. There 
shall be a designated area within the labora- 
tory for preparation of radioactive standards 
and samples. Precautions shall be taken in 
this area to ensure against radioactive con- 
tamination. Provisions shall be made for 
safe storage and disposal of radioactive 
wastes and for monitoring of the work area. 

Statutory Authority G.S. 130A-315. 

.0257 RADIOCHEMISTRY METHODS 

Minimum requirements and methods for 
radiochemical analyses shall be made in accord- 
ance with methods adopted in 15A NCAC ISC 
.1522 and may be obtained from the Department 
of Environment, Health, and Natural Resources, 
Division of Laboratory Services, 306 North 
Wilmington Street. Raleigh, North Carolina. 

Statutory Authority G.S. J30A-3/5. 

.0258 RADIOCHEMISTRY SAMPLE 

COLLECTION, HANDLING, AND 
PRESERVATION 

(a) Minimum requirements of sample handling 
for radiochemical analyses including sample con- 
tainer, preservation, and major instrumentation 
shall meet the criteria in Table YI-I in the EPA 
"Manual for the Certification of Laboratories 
Anal) zing Drinking Water", which is hereby 
adopted by reference pursuant to G.S. 
150B- 14(c).' 

(b) Samples shall be collected in containers 
provided by the laboratory'. 

(c) If composited samples are to be analyzed, 
the compositing shall be performed in the labo- 
ratory. 



(d) Sample report form. The sample report 
form shall contain the location; date and time of 
collection; collector's name; preservative added; 
and any other special remarks concerning the 
sample. Sample report forms shall be approved 
by the N.C. Public Water Supply Section. 
Indelible ink shall be used to complete the form. 

Statutory Authority G.S. 130A-3I5. 

.0259 RADIOCHEMISTRY QUALITY 
CONTROL 

Requirements for quality control of 
radiochemical analyses shall be as follows: 

(1) Quality control data and records shall be 
available for inspection. 

(2) The laboratory shall participate at least 
twice each' year in those EPA laboratory 
intercomparison studies that include each of 
the analyses for which the laboratory is, or 
wants to be, certified. Analytical results 
shall be within control limits described in 
"Environmental Radioactivity Laboratory 
Intercomparison Studies 
Program-FY-1977" (EPA-600/4-77-001), 
which is hereby adopted by reference in ac- 
cordance with G.S. 150B- 14(c). 

(3) The laboratory shall participate once each 
year in an appropriate unknown perform- 
ance study administered by EPA. Analytical 
results shall be within control limits estab- 
lished by EPA for each analysis for which 
the laboratory is, or wants to be, certified. 

(4) Operating manuals and calibration proto- 
cols for counting instruments shall be avail- 
able to analysts and technicians. 

(5) Calibration data and maintenance records 
on all radiation instruments and analytical 
balances shall be maintained in a permanent 
record. 

(6) The following specifications shall be in- 
cluded in minimum daily quality control: 

(a) To verify internal laboratory precision for 
a specific analysis, a minimum of 10 per- 
cent duplicate analyses shall be performed. 
The difference between duplicate meas- 
urements shall be less than two times the 
standard deviation of the specific analysis 
as described in EPA-600 4-77-001. If 'the 
difference exceeds two standard devi- 
ations, calculations and procedures shall 
be examined, and samples shall be reana- 
lyzed. 

(b) When 20 or more specific analyses are 
performed each day, a performance 
standard and a background sample shall 
be measured with each 20 samples. If less 
than 20 specific analyses are performed in 



361 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



PROPOSED RULES 



any one day, a performance standard and 
a background sample shall be measured 
along with the samples, 
(c) Quality control performance charts, or 
performance records, shall be available for 
inspection. 

Statutory Authority G.S. I30A-315. 

.0260 RADIOCHEMISTRY DATA 

Records and data reporting shall be maintained 
in accordance with the EPA "Manual for the 
Certification of Laboratories Analyzing Drinking 
Water", Chapter 6, Section 8.2-8.3.6, which is 
hereby adopted by reference pursuant to G.S. 
1 SOB- 14(c). 

Statutory Authority G.S. 130A-315. 

.0261 RADIOCHEMISTRY ACTION RESPONSE 

All laboratory results exceeding maximum con- 
taminant levels shall be reported to the Public 
Water Supply Section of the Division of Envi- 
ronmental Health within 48 hours. All other 
laboratory results shall be reported in accordance 
with the Public Water Supply rules in 15A 
NCAC 18C. 



Statutory Authority G.S. 130A-3I5. 
CHAPTER 21 - HEALTH: PERSONAL HEALTH 

SUBCHAPTER 21 A - WOMEN'S PREVENTIVE 
HEALTH 

SECTION .0100 - GENERAL POLICIES 

.0107 SUBMISSION OF REQUIRED REPORTS 

(a) Local providers funded by the branch shall 
submit patient master records, pati e nt ¥tstt- re- 
corda, as4 shipment control a*4 supplemental 
ocrvieo sheets data and service statistics in ac- 
cordance with Health Services Information Sys- 
tem requirements. 

(b) Local providers shall report on selected 
statistics on clinical effectiveness as sampled by 
the branch. All required reports and submission 
dates are listed on the reverse side of the local 
health department budget page. 

(c) Local providers shall participate in the cost 
and time study conducted by the Department. 

Statutory Authority G.S. I30A-124. 



CHAPTER 25 - LOCAL STANDARDS 
SECTION .0200 -STANDARDS FOR LOCAL HEALTH DEPARTMENTS 

.0213 FOOD, LODGING/INST SANITATION/PUBLIC SWIMMING POOLS/SPAS 

(a) A local health department shall provide food, lodging, and institutional sanitation and public 
swimming pools and spas services within the jurisdiction of the local health department. A local health 
department shall establish, implement, and maintain written policies which shall include: 

(1) The frequency of inspections of food, lodging, and institutional facilities and public swimming 
pools and spas with the following being the minimum: 



Type of Fstablishment 

Bed and breakfast homes 
Child day-care facilities 
Institutions 

Local confinement facilities 
Lodging 
Meat markets 
Meat markets or 

summer camps which are closed for 
a period of 60 days or more 
Migrant housing water and sewage 
evaluation 
Mobile food units 

Private boarding schools and colleges 
Public swimming pools and spas 

Pushcarts 

Residential care facilities 

Restaurants 

Schools 



Frequency 

1/year 

4- 2/year 

2,'year 

1/year 

1/year 

4/year 

1/3 months 

of operation 

(or part thereof) 

3 1/year 

4/year 

1/year 

1 operational 

season 

4/year 

1/year 

1 /quarter 

1/year 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



362 



PROPOSED RULES 



Summer camps 

Vending machine locations 



1 /year 

Roprgjiontativo 
number ef- 
locatioFin/yoar 



For the purpose of restaurant inspections, a food sampling inspection shall fulfill the requirement 
of an inspection provided a minimum of three distinct samples are taken from the restaurant. A 
maximum of one food sampling inspection per restaurant, per year, may be used to meet the 
quarterly inspection requirement for restaurants. 



Statutory Authority G.S. 130A-9. 

TITLE 21 - OCCUPATIONAL LICENSING 
BOARDS 



lyotice is hereby given in accordance with G.S. 
I SOB- 12 that the Board of Medical Examiners of 
the State of North Carolina intends to amend 
rule(s) cited as 21 NCAC 32E .0003. 



Th 



he proposed effective date of this action is No- 
vember 1, 1991. 

1 he public hearing will be conducted at 12:00 
p.m. on August 2. 1991 at the NC Board of Med- 
ical Examiners, 1313 Navaho Drive, Raleigh, N.C. 
2~609. 

C omment Procedures: Persons interested may 
present written or oral statements relevant to the 
actions proposed at a hearing to be held as indi- 
cated above. Written statements not presented at 
the hearing should be directed to the following 
address: Administrative Procedures, NC Board 
of Medical Examiners, P.O. Box 26S0S, Raleigh, 
NC 27611-6808. 

CHAPTER 32 - BOARD OF MEDICAL 
EXAMINERS 

SUBCHAPTER 32F - BIENNIAL 
REGISTRATION 

.0003 FEE 

Each physician shall pay a biennial registration 
fee of seveaty dollar - : . ($70.00) one hundred dol- 
lars (? 100.00) to the Board; except, each physi- 
cian holding a resident's training license shall pay 
a biennial registration fee of twenty-five dollars 
($25.00). 

Statutory Authority G.S. 90-15.1 . 

•k-k-kk-k-k-k-k-k-k-k-k-k-k-k-kkk 



l\otice is hereby given in accordance with G.S. 
1 SOB- 12 that the North Carolina Board of Phys- 
ical Therapy Examiners intends to amend rule(s) 
cited as 21 NCAC 48 A .0005; 48B .0002; 48D 
.0005; 48E .0110. 

1 he proposed effective date of this action is No- 
vember 1, 1991. 

1 he public hearing will be conducted at 2:00 
p.m. on August 1, 1991 at 900 Ridgefield Drive, 
Suite 250, Raleigh, NC 27609. 

O omment Procedures: Interested persons may 
present their views either orally or in writing at the 
hearing. In addition, the record of hearing will 
be open for receipt of written comments from July 
1, 1991, to 5:00 p.m. on July 31, 1991. Such 
written comments must be delivered or mailed to 
Constance Peake, N.C. Board of Physical Ther- 
apy Examiners, 2426 Try on Road, Durham, NC 
27705. 

CHAPTER 48 - BOARD OF PHYSICAL 
THERAPY EXAMINERS 

SUBCHAPTER 48A - ORGANIZATION 

.0005 DEFINITIONS 

The following definitions and the definitions in 
G.S. 90-270.24 will apply throughout Chapter 
48: 
(1) "Education programs" "Educational pro- 
grams" means accredited physical therapy 
programs and accredited physical therapist 
assistant programs. 

Statutory Authority G.S. 90-270.24; 90-270.26; 
90-270.31. 

SUBCHAPTER 48B - TYPES OF LICENSES 

.0002 LICENSES BY ENDORSEMENT 

(a) Endorsement. Each application for 
endorsement will be considered on an individual 
basis. 



363 



6:7 NORTH CAROLINA REGISTER July I, 1 99 1 



PROPOSED RULES 



(b) Examination Required. Only those per- 
sons initially licensed in another state by virtue 
of examination will be considered for endorse- 
ment. Only the following examinations will be 
considered: 

(1) For Physical Therapists: 

(A) Therapists licensed on the basis of a 
PT exam must present total scores that 
meet the North Carolina passing level. If 
adequate scores and information are not 
available from the other state, the Board 
may ask the applicant to have his scores 
issued through the appropriate testing 
service. If the total score on a»y part ©f 
the examination is unsatisfactory, the 
exam must be repeated. The cost of the 
examination will be paid by the applicant. 

Statutory Authority G.S. 90-270.26; 

90-270.31 (b); 90-270.33. 

SUBCHAPTER 48D - EXAMINATIONS 

.0005 EXAMINATION SCORES 

(a) Passing Level. The passing level for the 
PT exam and the PTA exam shall be 1.5 stand- 
ard deviations below the national average for the 
raw score of the examination. All individual 
parts a«4 the total score must moot the passing 
lovol fof a porson t© pass the examination. 

fb) Failure ©f Examination: 
(4} Aft examinee f»ay be failed ©ft either part 
score ©f total score. 14 the required mini 

QT^JT^ ^^^^^^^^ t^i I I ^ I t -\ , t 1 ^^ 4 ■ I | I . \ . I V~V I it fF^A 

I I HUII 1HT.'1U PTT III I T 1 '111 I T^ RCoCQ , t ' T_Il 1 1 IV 

total scoro is passed, only the part which 
is failed must be repeated. Even if aU- 
parts have boon passed at- ©«e time ©f an- 
other, a passing total scor e »» the e ntire 
examination must be received at- ©«e sit- 

Hftgr 

(b) (e+ Transfer of Scores. Scores will be re- 
leased as follows: 

(1) To an individual who took the examina- 
tion m North Carolina at his request and 
with no charge; 

(2) To licensing Boards in other states upon 
the request of the individual and the pay- 
ment of the fee; licensure information may 
be included with the score release; 

(3) To other persons or institutions upon the 
request of the individual. 

(c) (*ty Scores Related to Passing Level. Scores 
released to the individual will include the North 
Carolina passing level for the examination. 

Statutory Authority G.S. 90-270.26; 90-270.33. 



SUBCHAPTER 48E - APPLICATION FOR 
LICENSURE 



SECTION .0100 - REQUIREMENTS 



(2) 



.0110 FOREIGN-TRAINED PHYSICAL 
THERAPISTS 

(b) Supporting Documents. In addition to the 
other requirements of this Section and G.S. 
90-270.30, each foreign-trained applicant must 
submit the following: 

(1) If the applicant has been graduated from 
a physical therapy educational program, a 
certification of physical therapy education 
is to be submitted directly to the Board. 

If the applicant does not meet the re- 
quirements of (b)(1) of this Rule, the 
Board will examine the applicant's educa- 
tional background to determine if the 
general college and professional instruc- 
tion is substantially equivalent to that of 
a United States physical therapy educa 
t+©» educational program. At a mini- 
mum, 120 semester hours of college 
education is required, which includes a 
minimum of 57 semester hours of profes- 
sional curriculum, including basic health 
sciences, clinical sciences and clinical edu- 
cation. It is the responsibility of the ap- 
plicant to make arrangements with a 
credentialing service acceptable to the 
Board to have the credentials evaluated. 
The Board will make its own review of 
applicant's educational program and is 
not bound by the findings of the creden- 
tialing service. 

Statutory Authority G.S. 90-270.26; 90-270.29; 
90-270.30; 90-270.31. 

TITLE 25 - OFFICE OF STATE 
PERSONNEL 

iV otice is hereby given in accordance with G.S. 
1 SOB- 1 2 that the Office of State Personnel! State 
Personnel Commission intends to amend rule(s) 
cited as 25 NCAC IB .0432; 1C .0405, .0407; and 
repeal rule(s) cited as 25 NCAC IK .0701 - 
.0708. 

1 he proposed effective date of this action is No- 
vember 1 , 1991 . 



Th 



he public hearing will be conducted at 9:00 
a.m. on August 7, 1991 at the Personnel Develop- 
ment Center, 101 W. Peace Street. Raleigh, North 
Carolina. 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



364 



PROPOSED RULES 



Cc 



omment Procedures: Interested persons may 
present statements either orally or in writing at the 
Public Hearing or in writing prior to the hearing 
by mail addressed to Drake Maynard, O/Jice of 
State Personnel, 1 16 W. Jones Street, Raleigh, 
North Carolina 27603. 

CHAPTER 1 - OFFICE OF STATE PERSONNEL 

SUBCHAPTER IB -STATE PERSONNEL 
COMMISSION 

SECTION .0400 - APPEAL TO COMMISSION 

.0432 REMEDIES FOR PROCEDURAL 
VIOLATIONS 

(b) Failure to give specific reasons for dis- 
missal, demotion or suspension without pay shall 
be deemed a procedural violation. The Person- 
nel Commission, in its discretion, may award 
back pay, »ft4 attorney's fees, or both for such a 
violation. ©Ft i+ may determin e that- the violation 
is se- severe that- it- rises to the level to constitute 
laek- »£ substantive j«st- cause; s«eh a dotermi 
nation shall require reinstatement, back pay a»4 
attorney's fees as remedies. Back pay or attor- 
ney's fees, or both, may be awarded for such a 
penod of time as the Commission determmes. in 
its discretion, to be appropriate under all the cir- 
cumstances. 



Statutory Authority 
126-37; 126-38. 



G.S. 126-4(9); 126-35; 



SUBCHAPTER 1C - PERSONNEL 
ADMINISTRATION 

SECTION .0400 - APPOINTMENT 

.0405 TEMPORARY APPOINTMENT 

A temporary appointment is an appointment 
for a limited term, normally not to exceed three 
to six months, to a permanent or temporary po- 
sition. When sufficiently justified, a longer pe- 
riod of time may be requested; but in no case 



shall the temporary employment period exceed 
12 consecutive months. (If retired employees 
sign a statement that they are not available for 
nor seek permanent employment, they may have 
tempo rary appointments for more than 12 
months). 

Statutory Authority G.S. 126-4.5. 

.0407 TEMPORARY PART-TIME 
APPOINTMENT 

A temporary part-time appointment is an ap- 
pointment of less than full-time for a limited term 
normally not to exceed three to six months. 
When sufficiently justified, a longer period of 
time may be requested; but in no case shall the 
temporary employment period exceed 12 con- 
secutive months. (Exception: If retired em- 
ployees sign a statement that they are not 
available for nor seek permanent employment, 
they may have temporary part-time appoint- 
ments for more than 12 months.) 



Statutory Authority G.S. 126-4. 
SUBCHAPTER IK - PERSONNEL TRAINING 

SECTION .0700 - PUBLIC MANAGER 
PROGRAM 

.0701 PROGRAM ADMINISTRATION 

(REPEALED) 
.0702 PURPOSE (REPEALED) 
.0703 PROGRAM ACCREDITATION 

(REPEALED) 
.0704 PROGRAM CURRICULUM (REPEALED) 
.0705 PROGRAM PARTICIPATION 

(REPEALED) 
.0706 CERTIFICATE OF COMPLETION 

(REPEALED) 
.0707 PRINCIPLES RELEVANT TO 

CURRICULUM DESIGN (REPEALED) 
.0708 FUNDING FOR PROGRAM (REPEALED) 

Statutory Authority G.S. 126-4. 



365 



6:7 NORTH CAROLINA REGISTER July I, 1991 



ARRC OBJECTIONS 



Th 



he Administrative Rules Review Commission (ARRC) objected to the following rules in accord- 
ance with G.S. 143B-30.2(c). State agencies are required to respond to ARRC as provided in G.S. 

143B-30.2(d). 



ADMINISTRATION 

Auxiliary Services 

/ NCAC 4G .0212 - Telefax and Telegraph Proposals 
Agency Revised Rule 

AGRICULTURE 

Plant Industry 

2 NCAC48F .0306 - Collection and Sale of Venus Flytrap 
Agency Revised Rule 

ECONOMIC AND COMMUNITY DEVELOPMENT 

Banking Commission 

4 NCAC 3G .0203 - Expiration and Renewal 

Agency Revised Rule 
4 NCAC 3G .0502 - Annual Report 

Agency Revised Rule 
4 NCAC 3G .0601 - Revocation or Suspension; Hearings 

Agency Revised Rule 

Hazardous Waste Management Commission 

4 NCAC 18 .0309 - Final Site 

Agency Returned Rule Unchanged 

Agency Revised Rule 

ENVIRONMENT, HEALTH, AND NATURAL RESOURCES 

Adult Health 

ISA NCAC 16 A .0804 - Financial Eligibility 

No Response from Agency 

Agency Responded 

No Response from Agency 
15A NCAC 16A .0806 - Billing the HIV Health Services Program 

No Response from Agency 

Agency Responded 

No Response from Agency 

Coastal Management 

ISA NCAC 7 J .0409 - Civil Penalties 
Agency Returned Rule Unchanged 
Rule Returned to Agency 



ARRC Objection 5/16/9/ 
Obj. Removed 5/16/91 



ARRC Objection 4/18/91 
Obj. Removed 4/18/91 



ARRC Objection 3/21/91 

Obj. Removed 4/18/91 

ARRC Objection 3/21/91 

Obj. Removed 4/18/91 

ARRC Objection 3/21/91 

Obj. Removed 4/18/91 



ARRC Objection 1/18/91 

No Action 2/25/91 

ARRC Objection 4/18/91 

Obj. Removed 5/16/91 



ARRC Objection 

No Action 
No Action 


1/18/91 
2/25/91 
3/21/91 
4/18/91 


ARRC Objection 

No Action 
No Action 


1/18/91 
2/25/91 
3/21/91 
4/18/91 


ARRC Objection 
No Action 
No Action 


1/18/91 
2/25/91 
4/18/91 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



366 



ARRC OBJECTIONS 



Agency Filed Rule with OAH 
Environmental Health 

ISA NCAC 18A .2537 - Appeals 

Agency Responded 

Agency Withdrew Rule 
15A NCAC ISA .2616 - Requirements for Employees 

Agency Revised Rule 
15A NCAC ISA .2618 - Cleaning of Equipment and Utensils 

Agency Responded 

Agency Raised Rule 
ISA NCAC ISA .2711 - Toilet Facilities 

Agency Responded 

Agency Revised Rule 

HUMAN RESOURCES 

Facility Services 



Rule Eff. 



6/1191 



?/ 91 



A RRC Objection 

No Action 4 18/91 

5116/91 



A RRC Objection 
Obj. Removed 


4; 18/91 
51 16/91 


A RRC Objection 
No Action 
Obj. Removed 


3/21/91 

4 18 91 
5 116 91 


A RRC Objection 
No Action 
Obj. Removed 


321 91 
4/18/91 

5,16,91 



10 NCAC 

Agency 
10 NCAC 

Agency 
10 NCAC 

Agency 
10 NCAC 

Agency 
10 NCAC 

Agency 
10 NCAC 

Agency 
10 NCAC 

Agency 
10 NCAC 

Agency 



3C .0914 - Defs Applicable. Psychiatric. Substance Abuse Svcs 

Revised Rule 

3J .2401 - Requirement for Operations Manual 

Revised Rule 

3T .0102 - Definitions 

Revised Rule 

3T .0603 - Home Health Aide Services 

Re\ised Rule 

3T .1101 - Administration 

Revised Rule 

3T .1112 - Design and Construction 

Revised Rule 

3T .1114 - Plumbing 

Revised Rule 

3T .1206 - Hospice Inpatient Fire and Safety Requirements 

Revised Rule 



Individual and Family Support 

10 NCAC42B .1201 - Personnel Requirements 

No Response from Agency 

Agency Returned Rule Unchanged 
10 NCAC 42C .2001 - Qualifications of Administrator 

No Response from Agency 

Agency Returned Rule Unchanged 

10 A CAC 42C .2002 - Qualifications of Supervisor-in-Charge 

No Response from Agency 

Agency Returned Rule Unchanged 
10 NCAC 42C .2006 - Qualifications of Activities Coordinator 

No Response from Agency 

Agency Returned Rule Unchanged 
10 NCAC42C .3301 - Existing Building 

Agency Returned Rule Unchanged 

Agency Filed Rule with OAH 
10 NCAC 42D .1401 - Qualifications of Administrator, Co-Administrator 



A RRC Objection 
Ob/. Removed 


418.91 
4, 18 91 


ARRC Objection 
Obj. Removed 


4.18 91 
4/18/91 


ARRC Objection 
Obj. Removed 


4 18. 91 
4 18 91 


ARRC Objection 
Obj. Removed 


4 18 91 
4 IS 91 


ARRC Objection 
Obj. Removed 


4 18,91 
4 18,91 


ARRC Objection 
Obj. Removed 


4 18:91 

4 18 91 


ARRC Objection 
Obj. Removed 


4 IS 91 
4 18 91 


ARRC Objection 
Obj. Removed 


4 IS 91 
4 18 91 


ARRC Objection 
No Action 


11 8 91 
2 25 91 
3/21/91 


ARRC Objection 
No Action 


1 18 91 

2 25. 91 

3 21 91 


ARRC Objection 
No Action 


1 1891 

2 25 91 

3 21 91 


ARRC Objection 
No Action 


1 IS 91 

2 25 91 

3 21 91 


ARRC Objection 
No Action 
Rule Eff 


11 14 90 

12 20 90 
5 01 91 


ARRC Objection 


11 14 90 



367 



6:7 NORTH CAROLINA REGISTER July I, 1991 



ARRC OBJECTIONS 



Agency Returned Rule Unchanged 
Agency Filed Rule with OAH 

Social Services 

10 NCAC 24 A .0303 - S el /County Board Members/ Social Svcs Comm 
10 NCAC 39D .0202 - Conciliation Procedure 

Agency Revised Rule 
10 NCAC 39D .0408 - Participation Expenses 

Agency Revised Rule 
10 NCAC 39D .0409 - One-Time Work Related Expenses 

Agency Revised Rule 
10 NCAC 39D .0411 - Supportive Svcs/ /Available in Non-JOBs Counties 

Agency Revised Rule 

JUSTICE 

NC Criminal Justice Education 

12 NCAC 9B .0301 - Certification of Instructors 

Agency Revised Rule 
12 NCAC 9B .0302 - General Instructor Certification 

Agency Revised Rule 

LABOR 



No Action 
Rule Eff 



12/20/90 
5/01/91 



ARRC Objection 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 



ARRC Objection 4/18/91 

Obj. Removed 5/16/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 



Migrant Housing 

13 NCAC 16 .0201 - Conduct of Preoccupancy Inspections 

Agency Revised Rule 
13 NCAC 16 .0301 - Provisional Occupancy 

Agency Revised Rule 
13 NCAC 16 .0302 - Provisional Occupancy Denied 

Agency Revised Rule 
13 NCAC 16 .0303 - Inspection of Provisionally Occupied Housing 

Agency Revised Rule 

LICENSING BOARDS AND COMMISSIONS 

Auctioneer's Commission 

21 NCAC 4B .0602 - Advertising 
Agency Revised Rule 

Cosmetic Art Examiners 



ARRC Objection 4/18/91 

Obj. Removed 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 

ARRC Objection 4/18/91 

Obj. Removed 4/18/91 



ARRC Objection 3/21/91 
Obj. Removed 4/18/91 



21 NCAC 14F .0010 - Sanitary Rules 

21 NCAC I4G .0017 - Changes in Teaching Staff 

21 NCAC 141 .0302 - Library 

Agency Responded 

Agency Revised Rule 
21 NCAC 141 .0304 - Classroom Work 
21 NCAC 14L .0210 - Effect on Student-Teacher Ratio 

Agency Responded 

Agency Revised Rule 



ARRC Objection 5/16/91 

ARRC Objection 5/16/91 

ARRC Objection 2/25/91 

No Action 3/21/91 

Obj. Removed 4/18/91 

ARRC Objection 5/16/91 

ARRC Objection 2125/91 

No Action 3/21/91 

Obj. Removed 4/18/91 



6:7 NORTH CAROLINA REGISTER July I, 1991 



36S 



ARRC OBJECTIONS 



Dental Examiners 

21 XCAC 16C .03/0 - Reexamination 

Agency Withdrew Rule 
21 NCAC 16D .0101 - Eligibility Requirements 

Agency Revised Rule 

Medical Examiners 

21 SCAC 32B .0309 - Personal Interview 
Agency Responded 
Rule Returned to Agency 

Mortuary Science 

21 XCAC 34C .0/02 - Applicability of Statutes 
Agency Withdrew Rule 

STATE PERSONNEL 



ARRC Objection 3/21/91 

4/18/91 

ARRC Objection 3/21/91 

Obj. Removed 4/18/91 



ARRC Objection 2/25/91 

No Action 3/21/91 

5/16/91 



ARRC Objection 5/16/91 
5/16/91 



25 XCAC ID .0509 - Severance Salary Continuation 
Agency's Response Unacceptable 
Rule Returned to Agency 



ARRC Objection 1/18/91 
2/25/91 
4/18/91 



369 



>: 



NORTH CAROLINA REGISTER July /, 1991 



RULES INVALIDA TED BY JUDICIAL DECISION 



1 his Section of the Register lists the recent decisions issued by the North Carolina Supreme Court, 
Court of Appeals, Superior Court (when available), and the Office of Administrative Hearings which 
invalidate a ride in the North Carolina Administrative Code. 



10 NCAC 261 .0101 - PURPOSE: SCOPE/NOTICE OF CHANGE IN LEVEL OF CARE 

10 NCAC 261 .0102 - REQUESTS FOR RECONSIDERA TION AND RECIPIENT APPEALS 

10 NCAC 261 .0104 - FORMAL APPEALS 

Thomas R. West, Administrative Law Judge with the Office of Administrative Hearings, declared Rules 
10 NCAC 261 .0101, 10 NCAC 261 .0102 and 10 NCAC 261 .0104 void as applied in Linda Allred, 
Petitioner v. North Carolina Department of Human Resources, D his ion of Medical Assistance, Re- 
spondent (90 DHR 0940). 

10 NCAC42W .0003(c) - COUNTY DEPT OF SOCIAL SERVICES RESPONSIBILITIES 
10 NCAC 42W .0005 - REPORTING CASES OF RAPE AND INCEST 

The North Carolina Court of Appeals, per Judge Robert F. Orr, declared Rules 10 NCAC 42W 
.0003(c) and 10 NCAC 42W .0005 void as applied in Rankin Whittington, Daniel C Hudgins, Dr. Takey 
Crist, Dr. Gwendolyn Boyd and Planned Parenthood of Greater Charlotte, Inc., Plaintiffs v. The North 
Carolina Department of Human Resources, David Flaherty, in his capacity as Secretary of the North 
Carolina Department of Human Resources, The North Carolina Social Services Commission, and C. 
Barry McCarty, in his capacity as Chairperson of the North Carolina Social Services Commission, De- 
fendants [100 N.C. App. 603, 398 S.E.2d 40 (1990)]. 

16 NCAC 6D .0105 - USE OF SCHOOL DA Y 

The North Carolina Supreme Court, per Associate Justice Henry E. Frye, held invalid Rule 16 NCAC 
6D .0105 as decided in The State of North Carolina; The North Carolina State Board of Education; and 
Bob Etheridge, State Superintendent of Public Instruction, Plaintiffs v. Whittle Communications and The 
Thomasville City Board of Education, Defendant- Counterclaimants and The Davidson County Board of 
Education, Defendant- Intervenor and Counterclaimant v. The State of North Carolina; The North 
Carolina State Board of Education; and Bob Etheridge, State Superintendent of Public Instruction; and 
Howard S. Haworth; Barbara M . Tapscolt; Kenneth R. Harris; Teena Smith Little; W.C. Meekins Jr.; 
Mary B. Morgan; Patricia H . Neal; Cary C Owen; Donald D. Pollock; Prezell R. Robinson; Norma 
B. Turnage; State Treasurer Harlan E. Boyles; and Lt. Governor James C Gardner; in their official 
capacities as members of The North Carolina State Board of Education, Counterclaim Defendants [328 
N.C. 456, 402 S.E.2d 556 (1991)]. 

15A NCAC 7H .0308 - SPECIFIC USE STANDARDS 

The North Carolina Court of Appeals, per Judge Sidney S. Eagles Jr., held that it was error for the 
Coastal Resources Commission to fail to follow the required notice and comment procedure prior to 
the adoption of temporary rule 15A NCAC 7H .0308(a)(l)(.\l), but that the CRC followed proper 
procedures when it adopted the text of the temporary rule as a permanent rule [15A NCAC 7H 
.0308(a)( 1)(M)]. Conservation Council of North Carolina v. Haste [102 N.C. App. 411, 402 S.E.2d 447 
(1991)]. 



6:7 NORTH CAROLINA REGISTER July 1, 1991 370 



NORTH CAROLINA ADMINISTRA TIVE CODE CLASSIFICA TION SYSTEM 



The North Carolina Administrative Code (NCAC) has four major subdivisions of rules. Two 
of these, titles and chapters, are mandatory. The major subdivision of the NCA C is the title. 
Each major department in the North Carolina executive branch of government has been as- 
signed a title number. Titles are further broken down into chapters which shall be numerical 
in order. The other two, subchapters and sections are optional subdivisions to be used by 
agencies when appropriate. 

TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE 



TITLE DEPARTMENT 

1 Administration 

2 Agriculture 

3 Auditor 

4 Economic and Community 

Development 

5 Correction 

6 Council of State 

7 Cultural Resources 

8 Elections 

9 Governor 

10 Human Resources 

1 1 Insurance 

12 Justice 

13 Labor 

14A Crime Control and Public Safety 

15A Environment, Health, and Natural 
Resources 

16 Public Education 

1 7 Revenue 

18 Secretary of State 
19A Transportation 
20 Treasurer 

*21 Occupational Licensing Boards 

22 Administrative Procedures 

23 Community Colleges 

24 Independent Agencies 

25 State Personnel 

26 Administrative Hearings 



LICENSING BOARDS 


CHAPTER 


Architecture 


2 


Auctioneers 


4 


Barber Examiners 


6 


Certified Public Accountant Examiners 


8 


Chiropractic Examiners 


10 


General Contractors 


12 


Cosmetic Art Examiners 


14 


Dental Examiners 


16 


Electrical Contractors 


18 


Foresters 


20 


Geologists 


21 


I learing Aid Dealers and Fitters 


22 


Eandscape Architects 


26 


landscape Contractors 


2S 


Marital & Family Therapy 


31 


Medical Examiners 


32 


Midwifer>' Joint Committee 


33 


Mortuary Science 


34 


Nursing 


36 


Nursing Home Administrators 


37 


Occupational Therapists 


38 


Opticians 


40 


Optometry 


42 


Osteopathic Examination and 


44 


Registration (Repealed) 




Pharmacy 


46 


Physical Therapy Examiners 


4S 


Plumbing, Heating and Fire Sprinkler 


50 


Contractors 




Podiatry Examiners 


52 


Practicing Counselors 


53 


Practicing Psychologists 


54 


Professional Engineers and Land Survej 


r ors 56 


Real Estate Commission 


58 


Refrigeration Examiners 


60 


Sanitarian Examiners 


62 


Social Work 


63 


Speech and Language Pathologists and 


64 


Audiologists 




Veterinary Medical Board 


66 



Note: Title 21 contains the chapters of the various occupational licensing boards. 



Ml 



6:7 NORTH CAROLINA REGISTER July I, 1991 



CUMULA TIVE INDEX 



CUMULA TIVE INDEX 

(April 1991 - March 1992) 



1991 - 1992 

Pages Issue 

1 - 44 1 - April 

44 - 99 2 - April 

100 - 185 3 - May 

186 - 226 4 - May 

227 - 246 5 - June 

247 - 325 6 - June 

326 - 373 7 - July 



AO - Administrative Order 

AG - Attorney General's Opinions 

C - Correction 

FR - Final Rule 

GS - General Statute 

JO - Judicial Orders or Decision 

M - Miscellaneous 

NP - Notice of Petitions 

PR - Proposed Rule 

SO - Statements of Organization 

FR - Temporary Rule 



ADMINISTRATIVE HEARLNGS 

Hearings Division, 310 PR 

AGRICULTURE 

Plant Industry, 102 PR 

CORRECTION 

Division of Prisons, 35 FR, 87 FR, 209 FR 

ECONOMIC AND COMMUNITY DEVELOPMENT 

Alcoholic Beverage Control Commission, 4 PR 
Community Assistance, 104 PR 
Credit Union Division, 231 PR 

ENVIRONMENT, HEALTH, AND NATURAL RESOURCES 

Coastal Management, 299 PR 

Environmental Management, 197 PR, 271 PR 

Forest Resources, 300 PR 

Health: Epidemiology, 28 PR, 341 PR 

Health Services, 9 PR, 327 PR 

Marine Fisheries, 122 PR 

Wildlife Resources Commission, 84 PR, 170 PR, 198 PR, 301 PR 



6:7 NORTH CAROLINA REGISTER July 1, 1991 



372 



New Total 

Volume Title Chapter Subject Subscription* Quantity Price 

EHNR 90.00 

EHNR 

(includes Breathalizer) 75.00 

Education 30.00 

Revenue 75.00 

Revenue 60.00 

Secretary of State 30.00 

Transportation 90.00 

Treasurer 45.00 

Licensing Boards 75.00 

Licensing Boards 75.00 

Licensing Boards 

Administrative Procedures 75.00 

Community Colleges 10.00 

Independent Agencies 10.00 

State Personnel 60.00 

Administrative Hearings 10.00 



39 


15A 


11 - 18 


4(1 


15A 


19- 26 


41 


16 


1 - 6 


42 


17 


1 - 6 


43 


17 


7- 11 


44 


18 


1 - 7 


45 


19A 


1 - 6 


46 


20 


1 - 9 


4" 


21 


1 - 16 


48 


21 


17- 37 


49 


21 


38- 70 




22 


1 - 2 


50 


23 


1 - 2 


51 - 


24 


1 - 2 


52 


25 


1- 


53 


26 


1 -4 



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